Subdermal Contraceptive implant

What is it?

A birth control implant is a highly effective, modern and reliable method to prevent spontaneous pregnancy. An implant contains a hormonal agent and it is inserted under the skin. Usually, the active ingredient is etonogestrel, a biologically active progesterone derivative. An implant can also contain female sex hormones in their pure form (estrogen and progesterone). This is a relatively new but effective method. The implants are soft capsules containing an active ingredient.

How does it work?

Etonogestrel in birth control implants is not bio-degradable, so one implant can perform its functions for 3 years until the concentration of a hormone decreases to zero. A birth control effect is possible due to the following:

  • Complete ovulation inhibition; the egg is not released from the ovum and the sperm has nothing to fertilize;
  • The mucus produced by the uterine neck changes its properties and do not allow the sperm to move up the female reproductive tract.

Due to the fact that etonogestrel quickly enters the blood, ovulation inhibition occurs on the next day after the implant insertion. With time, the speed with which the content of the implant is released decreases, reaching its minimum during the third year of use. Breakdown products of etonogestrel are excreted in feces and urine, so women with acute or chronic renal failure and gastrointestinal diseases should use subdermal implants with much care. Breastfeeding mommies should also be careful as etonogestrel is eliminated in breast milk as well and can be consumed by a baby.

How is it inserted?


Subdermal implant is inserted under the skin on the outer part of the upper arm, approximately 10cm above the cubital fossa. If a woman is a right-hander, the implant is inserted into the left arm, if she is left-handed the implant is placed into the right arm. During the procedure, a woman is lying on her back. The length of the implant is 4cm and diameter is 2 mm. Under local anesthesia, a medical specialist makes a skin incision 2mm long and with a special applicator inserts a birth control implant. The procedure lasts for a couple of minutes. After insertion, the implant is well-palpable.

The implantation should be performed by an experienced specialist, in aseptic conditions and only after a complete medical examination of a patient to detect contraindications and exclude pregnancy.

Three years later when the implant ceased to have an effect, it is removed. To remove the capsule without any problems, it should be inserted correctly. If necessary, a doctor can recommend a repeated use.


Unlike subdermal implant, oral birth control pills do not have such a long-lasting effect. Its long-lasting effect against spontaneous pregnancy is one of its main advantages.

There are some other benefits:

  1. An implant is 99% effective against spontaneous pregnancy;
  2. There is no need to take the drugs regularly. A woman can forget about the problem of contraception for 3 years;
  3. Quick ovulation restoration after removal of the implant. It occurs within 3 weeks;
  4. The shot reduces the risk of developing some gynecological diseases (mastopathy, breast cancer, uterine fibroids, endometriosis);
  5. The development of infertility is excluded;
  6. Bad habits do not reduce the effectiveness of the shots;
  7. It does not have a negative effect on concentration so a woman can drive a car and work with complicated mechanisms;
  8. Price-performance ratio is fair. Although the implant is rather expensive, its long-lasting effect and virtually one hundred percent reliability justify its price.


Despite a lot of positive feedbacks about this birth control method, it has a number of disadvantages:

  • The implant protects against pregnancy but it is useless in protecting against sexually transmitted diseases. Having unsafe sex with an unreliable partner is a great risk to get infected.
  • Because it influences the female endocrine profile, a woman may experience menstrual disorders.
  • Implants can also lead to lower libido or weight changes.
  • Using the implant during lactation, the hormones can be taken up by a baby’s body which is undesirable.
  • There is a risk of negative side-effects.

Possible negative side-effects

The risk of negative side-effects is low but still we should not ignore it. It is all very individual and depends on the correctness of the procedure performance. The most common side-effects are:

  1. Headache;
  2. Dizziness;
  3. Acne;
  4. Irregular periods;
  5. Painful breasts;
  6. Change in appetite;
  7. Weight change.

Rare side-effects:

  • Alopecia;
  • Ovarian cyst;
  • Allergy;
  • Sleep disorders;
  • Arterial blood pressure increase;
  • Gastrointestinal disorders;
  • Swelling and bruising around the implant.

If all the rules concerning implant insertion and wearing have been observed, the risk of side-effects is near zero.