Birth Control Bingo: the Contraceptive Implant

  • 99+% effective with perfect and typical use; less than one out of every 100 women will become pregnant each year


Additional Sources for Effectiveness Ratings and Use:

  • 100% perfect use (clinical trials only) Contraceptive Technology, 18th Revised Edition; Hatcher, Trussell, Stewart, Nelson, Cates, Guest, Kowal: Ardent Media, 2004.
  • 99% typical and perfect use: Feminist Women's Health Center
  • 99.9% typical and perfect use: Planned Parenthood

The What, the Why, the Where, the When, and the How-to: The currently available contraceptive implant, Implanon, is a thin, plastic rod inserted subdermally (under the skin) by a healthcare provider in a woman's non-dominant arm which emits small amount of the hormone progestin over time. That progestin prevents pregnancy by suppressing ovulation and thickening cervical mucus, making it difficult for sperm to swim to the cervix.

A backup method of birth control should be used after insertion of the implant for two weeks before using the implant alone. One implant is effective for three years, and if a woman wants to stop using it, she can just have it removed. For those wishing to become pregnant, once removed, women will resume their normal fertility cycles.

Pros of the implant include not having to think about a method for as long as three years at a time, a very high level of effectiveness, no chance of user error, reduction of painful periods, and a method which doesn't interrupt sexual activities. The biggest complaint most women have with the implant is due to unpredictable spotting or bleeding which, for some, may be a constant. Some women may stop getting their periods, and may have very irregular periods; some may have heavier, longer periods than usual. Other unfavorable side effects may include those typical with many hormonal methods like weight gain, vaginal dryness, reduction of sex drive, nausea or an increase in headaches. The implant can pose cardiovascular risks, irritation of the injection site, difficulty in removing the implant, and some women are not good candidates for the implant, possibly including diabetics, those with high blood pressure, those suffering from depression or epileptics. Some other medications or drugs may reduce the effectiveness of the implant.

As well, one con may be that the implant is still relatively new, and many sexual healthcare providers and doctors are not yet providing it, or haven't finished their training in inserting it yet. So, depending on where you are and your own healthcare provider, it may not be available for you yet at this time.

We have had contraceptive implants before Implanon, the most recent being Norplant. Norplant was withdrawn from the U.S. market in the late 90's, largely due to lawsuits from women who had not been warned about side effects, and because several lots of Norplant had not met quality assurance standards. Implanon is new to the U.S., but has been used in other countries since 1998 by a couple million women with success.

For more information about Implanon, see:

When Good Birth Control Does Bad Things: It's very unlikely that an implant will fail, but if used with a medication or other srud that can decrease effectiveness it may fail, and if a woman does not get a new implant in time when her old one has expired, pregnancy may occur.

Other methods which can be used as a backup method with an implant: Implants are so effective and free of user error that unless using a medication known or suspected to decrease effectiveness, a backup is not likely needed after the first two weeks post-insertion. But if a backup is needed, it can be used with any non-hormonal method.

Other methods you might like if you like the implant:

Why would an implant be a good option for me? If any of the following are true:

  • You want a method where it's nearly impossible for you to mess up
  • You don't want a method you have to think about before, during or after the time of sex, or know you can't remember to do that
  • You are looking for a hormonal method without estrogen
  • You are looking for a method you rarely need to tend to
  • You want something which is very cost-effective long-term
  • You want something which is quickly reversible
  • You are currently breastfeeding

For a brief overview of all methods, have a look at Margaret Sanger's Disneyland: Choosing Contraceptives. Want to start over with Birth Control Bingo? Click here.


Don't forget: Statistically, sexually active young adults are as, if not more, likely to acquire a sexually transmitted infection (STI) as you are to become pregnant. Although 15-24-year-olds represent only one-quarter of the sexually active population, they account for nearly half of all new STIs each year, and of the 18.9 million new cases of STIs each year, 9.1 million (48%) occur among 15-24-year-olds (AGI). Often people have some funny ideas about who is most likely to get an STI, but the fact of the matter is that younger people -- of any sexual orientation, any economic class, any kind of relationship -- have been the highest risk group for some time now.

Condoms are the only method of birth control which also provide protection against STIs. It's pretty typical for younger people to ditch condoms if they have another method of birth control, so just remember that STIs are still a risk if you're using another method. You can read all about safer sex here -- Safe, Sound & Sexy: A Safer Sex How-To -- but the rule of thumb most medical experts and prevention organizations suggest, which we also encourage at Scarleteen is six months of safer sex, six months of sexual monogamy, and then TWO full STI screenings for each partner -- once at the start of that six months, once at the end -- before ditching latex barriers.