(Published July 2008)

Summary

Because of the unique history of subcutaneous progestin-only contraceptive implants, some misperceptions still prevail. Providers should remember the following:

• Insertion and removal are quick.
• Insertion and removal techniques are easy to learn.
• Irregular bleeding patterns are accepted by most women.
• Implants are not associated with high litigation risk for providers.
• The single-rod implant is practically invisible.
• Implant insertion is almost painless.
• Removal may be more difficult if the implant was inserted improperly.
• Insertion site infection is rare.
• There are no long-term health problems with use and no problems in children conceived after removal.
• There is minimal effect on libido.

The single-rod implant has many advantages.¹ It is a highly effective contraceptive with no requirement for user compliance. It has a long life-span with a minimal requirement for medical follow-up. Metabolic effects are minimized by low, stable serum hormone levels. The single-rod implant offers a rapidly reversible, highly effective contraceptive method.

While all contraceptive methods have disadvantages, implants have few. The single-rod implant carries a high initial cost. If women continue to use the implant for the intended three years, this system of contraception becomes more cost effective. Considering the high costs of method failure, contraceptives such as the intrauterine device (IUD), injectables, and implants provide a cost effective alternative.

Women should be counseled properly to prevent early discontinuation. Insertion and removal requires a visit to a trained clinician with insertion taking under one minute and removal under three minutes. Women seeking oral contraceptives need to visit their physician as well as their pharmacy on a regular basis, all factors that should be considered when patients select a contraceptive method.

Some misperceptions still surround contraceptive implants but these are diminishing as clinical information accumulates from the many woman-years of use in over 40 developed and underdeveloped countries. Thousands of women have embraced this contraceptive method confirming that this second-generation, single-rod implant is safe and effective.

The single-rod implant is an advance in contraceptive options that offers women another reproductive health choice. It is a new method that fulfills an unmet need for a safe, highly effective, and rapidly reversible contraception. Most women who desire long-term contraception that is highly effective and rapidly reversible are candidates for implant use.

References:

1. Power J, French R, Cowan F. Subdermal implantable contraceptives versus other forms of reversible contraceptives or other implants as effective methods of preventing pregnancy. Cochrane Database Syst Rev. 2007 Jul 18;(3): CD001326.