CHAPTER 9 - Implants | Family Planning

Key Points for Providers and Clients
Implants are small flexible rods that are placed just under the skin of the upper arm. They provide long-term pregnancy protection. Implants are very effective for 3–5 years, depending on the type of implant, and they are immediately reversible. They require a specifically trained provider to insert and remove them. A woman cannot start or stop implants on her own. Little is required of the client once implants are in place. They avoid user errors and problems with resupply. Bleeding changes are common but not harmful. Typically, there is prolonged irregular bleeding over the first year, and then lighter, more regular bleeding, infrequent bleeding, or no bleeding.

Key Points for Providers and Clients

Implants are small flexible rods that are placed just under the skin of the upper arm.
They provide long-term pregnancy protection. Implants are very effective for 3–5 years, depending on the type of implant, and they are immediately reversible.
They require a specifically trained provider to insert and remove them. A woman cannot start or stop implants on her own.
Little is required of the client once implants are in place. They avoid user errors and problems with resupply.
Bleeding changes are common but not harmful. Typically, there is prolonged irregular bleeding over the first year, and then lighter, more regular bleeding, infrequent bleeding, or no bleeding.

What Are Implants?

Implants are small plastic rods, each about the size of a matchstick, that release a progestin like the natural hormone progesterone in a woman’s body.
A specifically trained provider performs a minor surgical procedure to place 1 or 2 rods under the skin on the inside of a woman’s upper arm.
They do not contain estrogen, and so can be used throughout breastfeeding and by women who cannot use methods containing estrogen.
Types of implants:
- Jadelle: 2 rods containing levonorgestrel (LNG), highly effective for 5 years
- Implanon NXT (also known as Nexplanon; replaces Implanon): 1 rod containing etonogestrel (ETG), labeled for up to 3 years of use (a recent study shows it may be highly effective for 5 years). Implanon NXT can be seen on X-ray and has an improved insertion device.
- Levoplant (Sino-Implant (II)): 2 rods containing LNG, labeled for up to 3 years of use
- Norplant: It consisted of 6 capsules and was effective for 5-7 years, but was discontinued in 2008 and is no longer available for insertion. A small number of women, however, may still need Norplant capsules removed.
Implants work primarily by:
- Preventing the release of eggs from the ovaries (ovulation)
- Thickening cervical mucus (this blocks sperm from reaching an egg