Contraceptive Implant - Mayo Clinic Lecture Notes

Overview

• Contraceptive Implant: A long-term birth control method named LARC (long-acting reversible contraception).
  • Releases a low, steady dose of the hormone progestin.
  • Flexible plastic rod, similar to a matchstick, placed under the skin of the upper arm.
  • Prevents pregnancy by:
    • Pausing ovulation
    • Thickening cervical mucus
    • Thinning the uterine lining

Benefits

• Reversible: Can be removed anytime by a healthcare provider.
• Convenient: Does not require daily or monthly attention.
• Autonomous: No need for partner's involvement.
• Estrogen-Free: Suitable for those at risk of blood clots associated with estrogen.
• Quick Return to Fertility: Pregnancy attempts can start immediately after removal.

Considerations

• Not suitable for everyone, especially those with:
  • Allergies to implant components
  • History of serious blood clots, heart attack, or stroke
  • Liver tumors or disease
  • History of breast cancer
  • Unexplained bleeding outside menstruation
• Medication Interaction: Some drugs and herbal products may reduce effectiveness.
  • Includes certain seizure medicines, sedatives, HIV medicines, and St. John's wort.

Risks

• Does not protect against sexually transmitted infections (STIs).
• Possibility of ectopic pregnancy if conception occurs.
• Side effects may include:
  • Back or stomach pain
  • Changes in menstrual cycle (e.g., amenorrhea)
  • Noncancerous ovarian cysts
  • Mood swings, depression
  • Nausea, headaches
  • Possible weight gain

Procedure Preparation

• Health assessment by care team.
• Possible pregnancy test prior to insertion.
• Use condoms or backup birth control initially unless placed:
  • In the first five days of menstruation.
  • After correctly using hormonal birth control methods.
  • While on minipill or due for a birth control shot.

Procedure Details

• Location: Under the skin of the upper arm.
• Process:
  • Local anesthetic administered.
  • Inserted just beneath the skin using an applicator.
  • Placement verified by touch or imaging (ultrasound/X-ray).
• Post-procedure:
  • Small bandage applied, pressure bandage optional.
  • Monitor for signs of complications, e.g., breast lumps or heavy bleeding.

Results

• Effective for up to three years.
• Requires replacement or removal at the three-year mark.
• Removal involves local anesthetic, small incision, and extraction.
• Option to replace immediately or switch to another birth control method.

Conclusion

• A contraceptive implant offers a long-term, low-maintenance birth control method with few responsibilities for daily management.
• Decision to use should be informed by personal health history and potential risks or side effects.
• Consultation with healthcare provider is essential to determine suitability.