The levonorgestrel implant is a small, flexible rod placed under the skin of the upper arm. It is a long-acting reversible contraceptive that continuously releases a low dose of the progestin hormone levonorgestrel. As a progestin-only method, it offers a convenient and effective birth control option.
How the Levonorgestrel Implant Prevents Pregnancy
The levonorgestrel implant works by continuously releasing a small, steady dose of the progestin levonorgestrel. This hormone primarily prevents pregnancy through several mechanisms. It causes the cervical mucus to become thicker and scantier, creating a barrier that makes it difficult for sperm to pass through and reach an egg.
The implant also thins the lining of the uterus, which makes it less receptive to a fertilized egg. Most significantly, levonorgestrel suppresses ovulation, preventing the ovaries from releasing an egg each month. While ovulation is inhibited in over 85% of cycles during the first year, the combination of these actions ensures high contraceptive efficacy.
The Procedure for Insertion and Removal
The insertion of a levonorgestrel implant is a quick, in-office procedure performed by a healthcare professional. After administering a local anesthetic to numb the inner side of the upper arm, typically about 8-10 cm above the elbow crease, a specialized applicator or trocar is used to place the small rod just beneath the skin. The process usually takes 1 to 4 minutes. Patients may feel a brief stinging sensation from the anesthetic, followed by some pressure, but generally minimal pain.
Removal also involves local anesthetic and is performed by a healthcare provider. A small incision, typically around 2-4 mm, is made near the implant’s tip, allowing for its gentle extraction. While removal can sometimes be more involved than insertion, it generally takes between 2 to 10 minutes. Patients might experience slight discomfort or bruising at the site for a few days, but recovery is typically swift.
Effectiveness and Advantages of the Implant
The levonorgestrel implant is a highly effective contraceptive method, with a typical effectiveness rate of over 99% in preventing pregnancy. This high efficacy is attributed to its consistent, continuous release of hormones, which eliminates the need for daily user action, unlike oral contraceptives. The low dose of progestogen released maintains consistent contraceptive protection.
A significant advantage of the implant is its long-term nature, providing contraception for up to three to five years. Its convenience stems from requiring no daily attention after insertion. The implant is also reversible, with fertility quickly returning after removal. As a progestin-only method, it is a suitable option for individuals who cannot use estrogen-containing contraceptives.
Common Side Effects and What to Expect
Changes in menstrual bleeding patterns are the most commonly reported side effect. Individuals may experience irregular bleeding, spotting, lighter periods, or a complete cessation of periods (amenorrhea). While generally not medically concerning, these changes can be unpredictable and are a frequent reason for discontinuation, particularly during the first 6-12 months as the body adjusts.
Other potential side effects include headaches, breast tenderness, and changes in weight or appetite. Some individuals may also experience acne or mood changes. Rarely, more serious risks can occur, such as infection at the insertion site or implant migration. An ectopic pregnancy, though rare, is also a serious risk if conception occurs.
Considerations for Use
Certain medical conditions and medications can influence the suitability of the levonorgestrel implant. Individuals with a history of breast cancer, severe liver disease, or active blood clots should generally not use this method. Unexplained vaginal bleeding also warrants investigation before considering the implant.
Some medications, particularly enzyme-inducing drugs, can reduce the implant’s effectiveness. It is important to discuss one’s full medical history and all current medications with a healthcare provider to determine if the implant is a safe and effective contraceptive option. A doctor can provide personalized advice.