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Contraceptive implant

Also called Jadelle®

Key points about the contraceptive implant

A contraceptive implant is a long-acting and reversible type of contraception.
It’s also called Jadelle®.
Find out how it’s used to prevent pregnancy and possible side effects.

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A contraceptive implant is a form of contraception for women, to prevent pregnancy. It contains the progestogen called levonorgestrel, a hormone similar to the one produced by ovaries. The implant doesn't contain oestrogen.

In Aotearoa New Zealand, the contraceptive implant is also called Jadelle®, the ‘implant’ or ‘rods’.

The implant is made up of 2 small rods (each about the size of a matchstick) that contain progestogen. The rods are placed under your skin, on the inside of your arm (you can feel the rods under your skin).
The implant works by slowly releasing progestogen into your bloodstream. Progestogen prevents pregnancy by making the mucus in your cervix thicker so sperm can’t travel through it to get to your egg. For most people it also stops your ovaries from releasing an egg each month.
The implant is called a long-acting form of contraception because it lasts for up to 5 years.
Its effect is reversible which means that your natural fertility returns to normal when the implant is removed.

Pros	Cons
✔ You don’t have to remember to take anything every day – it lasts for up to 5 years. ✔ It's reversible – you can choose to have it taken out at any time. ✔ It doesn’t interfere with having sex in the way that physical barrier methods do. ✔ It's highly effective and reliable for preventing pregnancy.	✘ It may cause irregular periods or periods that last longer. This is common in the first 6 months but can last for as long as you use the implant. This can be annoying, but it’s not harmful and the implant will still work. If the bleeding is a problem, talk to your healthcare provider. You can take medicine to help with this. ✘ It may cause a sore or bruised arm after the implant is put in or taken out. There is a small risk of infection. ✘ Sometimes it’s not easy for the nurse or doctor to find the implant and you might have to come back and have it removed with the help of an ultrasound scan. ✘ It doesn't protect against sexually transmitted infections (STIs), so it’s important to use condoms when you have sex with new partners or people whose sexual history you don't know. ✘ There may be a small scar from the insertion and removal of the implant.

Pros

Cons

✔ You don’t have to remember to take anything every day – it lasts for up to 5 years.

✔ It's reversible – you can choose to have it taken out at any time.

✔ It doesn’t interfere with having sex in the way that physical barrier methods do.

✔ It's highly effective and reliable for preventing pregnancy.

✘ It may cause irregular periods or periods that last longer. This is common in the first 6 months but can last for as long as you use the implant. This can be annoying, but it’s not harmful and the implant will still work. If the bleeding is a problem, talk to your healthcare provider. You can take medicine to help with this.

✘ It may cause a sore or bruised arm after the implant is put in or taken out. There is a small risk of infection.

✘ Sometimes it’s not easy for the nurse or doctor to find the implant and you might have to come back and have it removed with the help of an ultrasound scan.

✘ It doesn't protect against sexually transmitted infections (STIs), so it’s important to use condoms when you have sex with new partners or people whose sexual history you don't know.

✘ There may be a small scar from the insertion and removal of the implant.

The implant is a very reliable form of contraception.
It's usually 99% effective in preventing pregnancy, which means that about 1 out of every 100 women who use the implant will get pregnant each year.
The advantage of the implant is that it lasts for up to 5 years but it can be removed at any time.

You should only have a contraceptive implant inserted if it’s certain you’re not pregnant. The implant is usually inserted within 5 to 7 days of a period starting, to ensure you’re not hapū.

Using condoms, or the combined oral contraceptive pill can lower your risk of pregnancy before you get your implant put in. You might need to take a pregnancy test.

The implant will be inserted by a trained healthcare provider, in the inner side of your upper arm. A check will be made to ensure it's inserted correctly. Once this is confirmed, it's effective straight away.

You'll be given an injection of local anaesthetic first to numb your skin, and a special needle will be used to put the implant in place.
After the procedure, the area will be closed (with tape) and you'll need to keep the wound dry and bandaged for 3 days. Don't bump the area or lift anything heavy with your arm during this time.
The area may be bruised and sore for a few days, but the wound will soon heal like any other small cut.
If you didn’t get your implant inserted within the first 5 to 7 days of your period, you’re not protected until 7 days have passed. It’s recommended you use condoms for the first 7 days after your implant is inserted.

Here are some things to know when you have a contraceptive implant. Other things may be important as well, so ask your healthcare provider what you should know about.

Other medicines: The levonorgestrel in the contraceptive implant interacts with some medicines (eg, antiseizure medicines such as carbamazepine, lamotrigine or HIV medicines), herbal supplements (eg, St John’s Wort) and rongoā Māori, so check with your healthcare provider before starting any new medicines or supplements.
Replacement: The implant works for a maximum of 5 years. Your healthcare provider may recommend you get a replacement implant after 4 years as a precaution.
Pregnant: If you become pregnant, contact your healthcare provider.
Sexually transmitted diseases: the implant does not protect you from sexually transmitted diseases.
Changes: If you can no longer feel your implant or if you notice changes in the shape of the implant or if it becomes sore, let your healthcare provider know.
Removal: The implant can be taken out at any time if you’d like it removed. It requires a local anaesthetic to remove and you may need to have it removed with the help of an ultrasound scan.
After removal: Once the implant is removed there’s an almost immediate loss of contraceptive effect so you’re at risk of getting pregnant. If you don’t want to become pregnant, you must use another form of contraception straight after it’s removed.

Like all medicines, the contraceptive implant can cause side effects, although not everyone will get them.

Irregular bleeding

It's very common for the implant to cause changes in your periods (menstrual bleeding patterns) such as irregular bleeding, bleeding between periods, longer periods, spotting or no bleeding at all. It's most common for your periods to be lighter and less regular.

Changes in your periods don't affect its contraceptive effect – it’s not harmful and the implant will still work.

The irregular bleeding often settles with time but it can be annoying and if it's severe and continues, tell your healthcare provider. You can take medicine to help with this.

Other side effects

Side effects	What should I do?
Discolouration, bruising or swelling at the implant site	These last for a few days. Tell your doctor if this bothers you or if it doesn't go away.
Headache Migraine Signs of urinary tract infections such as peeing (urinating) more often than usual or a burning feeling when urinating	These are common. Tell your doctor if these bother you.
Feeling sick (nausea) Being sick (vomiting) Feeling dizzy Sore breasts Changes in mood or desire for sex (libido)	These are less common. Tell your doctor if these bother you.
Acne can improve or worsen	This is less common and is usually mild. Tell your doctor if this bothers you.
Severe pain in your tummy	This is rare. Call your doctor immediately or Healthline on 0800 611 116.
Signs of increased pressure around the brain such as frequent, severe, ongoing headaches or problems with your vision	This is very rare. Call your doctor immediately or Healthline on 0800 611 116.