The contraceptive implant — a flexible, matchstick-sized stick inserted under the skin of the arm — is one of the most effective and least known long-term contraceptive methods.
How it works
An implant (such as a Nexplanon-type device) continuously releases a small dose of progestin into the bloodstream, which suppresses ovulation and thickens cervical mucus. It is inserted under the skin on the inner surface of the upper arm, under local anesthesia, in just a few minutes — the procedure is as simple as an injection, just with a special applicator.
Efficiency
The implant is considered one of the most effective reversible contraceptives — the failure rate is below 1%, virtually identical between ideal and typical use, because, unlike the pill, it does not rely on daily user intervention. This makes it one of the most reliable methods in real life.
Duration
The approved use period varies depending on the model 3 to 5 years, although some studies indicate that effectiveness may be maintained for longer in some users — despite this, the official recommendation is to remove/replace within the approved period.
Common myth: "The implant is visible through the skin"
When inserted correctly, the implant is virtually invisible—it may be faintly noticeable when you insert a finger, but it is almost invisible, even under underwear or a short-sleeved shirt.
Cycle changes
The most common reason why users stop using the implant before it expires is a change in their menstrual cycle — this can range from complete cessation of bleeding (an advantage for some) to unexpected, irregular, prolonged spotting (a source of discomfort for others). This change is unpredictable for a given individual and is worth discussing with your doctor before starting to be prepared for the expected consequences.
Insertion and removal process
Both procedures are performed on an outpatient basis. Insertion is easier than removal — during removal, the doctor must manually feel the exact location of the implant under the skin, which in rare cases (if the implant is deep or displaced) can be technically difficult — which is why it is important to have the insertion/removal performed by an experienced, certified specialist.
Fertility restoration
After the implant is removed, hormone levels in the blood drop quickly, and fertility usually returns to baseline quickly — this is one of the advantages, unlike other methods focused on long-term results.
Who might it be a particularly good choice for?
The implant is a good choice for those who have difficulty taking a daily pill without forgetting, or for whom estrogen-containing contraception is contraindicated (for example, due to migraine aura, risk of thrombosis, or other medical reasons) — because the implant contains only progestin, the risks associated with estrogen are absent.
What does it not protect?
Like other hormonal methods, the implant does not protect against sexually transmitted infections in any way — the additional use of a barrier method remains necessary to protect against infections, even if the risk of pregnancy is reduced to virtually zero.