It's easy to stay protected from pregnancy with a contraceptive implant (also known as a sub-dermal implant or hormonal implant). You won't have to remember to take any medicines or do anything once it's fitted. This contraceptive is only suitable for women.
What is a contraceptive implant?
It's a small rod that's around 4cm in length with a diameter of 2mm and is fitted in the skin of your arm.
The implant releases the hormone progesterone which stops the ovaries from releasing an egg every month, a process called ovulation. You can't get pregnant if ovulation doesn't happen. It also thickens the mucus in the cervix (the opening of the uterus) and stops sperm from going up any further.
Although no contraceptive is 100% effective, the implant provides protection in more than 99% of women, making it one of the most effective contraceptives available.
The Implanon NXT is an implant available in Malta.
How is a contraceptive implant inserted?
It's fitted at a doctor's clinic during a very small surgical procedure. The doctor will first give you some local anaesthetic. Then, the implant is inserted just under the skin of your inner arm.
Once it's done, you'll be able to feel the rod under the skin but there shouldn't be any discomfort. Be sure to check it's still there and hasn't moved from time to time. If you think the rod is slowly changing its position, speak to your doctor.
For the implant to be immediately effective, time the insertion either during your period or immediately after the last tablet in a contraception pill pack.
How is it removed?
An implant keeps releasing hormones for 6 months to 3 years. The brands that are currently available in Malta are good for 3 years.
Once it's at the end of its lifetime, the implant is removed at a doctor's clinic. Again, you'll be given some local anaesthetic over the area. The doctor will then make a tiny cut in the skin and remove the rod.
You can get pregnant soon after it's removed. Unless that's your intention, be sure to either get another implant inserted, which can be done at the same visit, or use other types of contraception.
Take a look at this video to see an implant being inserted and removed:
What are the advantages of using an implant?
This contraceptive is ideal for women who cannot take or tolerate oestrogen since it uses a different hormone to stop ovulation.
Periods are usually lighter. If your periods stop altogether, there's no need to be alarmed since it's quite common after a year of use.
You can get this contraceptive and then forget all about it until it's time to get it replaced. It also doesn't interrupt sex.
If you're planning to get pregnant, you can do so immediately after removing the implant.
What are its disadvantages?
You'll need a small procedure to insert and remove it. Be sure to remember to replace it or use a different contraceptive after its time is up, otherwise you can get pregnant.
This contraceptive doesn't protect you against sexually transmitted infections (STIs). You'll need to use a condom too during sex. However, it's ideal for use during long-term relationships.
For the first few months after insertion, you may notice some bloating, breast tenderness or acne. These usually get better with time. Some also get persistent spotting of blood.
Some women might not be able to use it if they suffer from liver disease, have breast cancer or had it in the past, or have a history of heart disease, stroke, or other vascular disease. You also cannot use it if you think you might be pregnant. Discuss your medical history with your doctor to make sure this contraceptive is suitable for you.
How much does it cost and how do I get the implant in Malta?
In Malta the Implanon NXT, which is an implant that lasts for three years, costs around EUR 185. This does not include doctors' fees and clinic fees.
You can have the implant inserted, replaced, or removed at private gynaecology clinics, such as St James Hospital. Not every gynaecologist does implants, so be sure to check with them before you book your appointment. Unfortunately, the implant is not available on the public health service, and has to be paid for privately.
Honorable Mention: Contraceptive Injection
Sayana Press is an injectable contraceptive that is not an implant, because it is a liquid injection, but is easier to insert than an implant and can be injected by the woman herself. Sayana Press also contains the hormone progesterone and lasts for at least 13 weeks. It is also very cheap compared to other contraceptives.
Watch this video to learn how to inject Sayana Press: