Birth Control Experiences: Implanon/Nexplanon

[Johanna]

For those looking into the different methods of birth control to find what's right for them, here's one of several threads where users can report their experiences with a given method so that other users can get a more personal idea of what using a given method is like when they're looking into what might work best for them.

If you have used the implant, please report on it in the following format:

Pros: List what you have experienced as the pros or benefits -- the good parts -- of using this method.

Cons: List what you've experienced as the downsides or cons of using this method.

Ease of use: Talk about how easy -- or not -- it's been for you and/or your partner to use, access and afford this method, how it's worked out in your relationships, etc.

Effectiveness: Talk about how well this method has protected you from pregnancy, and if it ever has failed, note that, including any explanation of how or why, if you know or suspect how or why.

Feel free to also add any extra notes, hints or tips!

[Redskies]

Our volunteer Karyn wrote a blog series about her experiences, which you can find at these links:
Implanon Part 1: That Piece of Plastic Going In My Arm (decision and consultation)
Implanon Part 2: In Which There Is a Very Large Needle (insertion)
Implanon Part 3: The Upgrade (long-term observations, 3-year removal and replacement, Nexplanon)

[Redskies]

I started using the implant very soon after becoming sexually active in ways which have pregnancy risks, and then used it as a sole method.

Pros: It's one of the most effective methods, and is very, very effective - having only a minuscule risk of pregnancy, knowing I'd done everything reasonable to prevent pregnancy, and knowing I couldn't mess it up were all really important to me, and BIG pros. Thinking about and having to be responsible with contraception only once every three years was excellent. I'm medically excluded from combined hormonal methods, so this (a progestin-only method) is one of the reduced number of methods available to me. My periods became very infrequent, around one every three months (a big pro for me because I'm not a fan of periods and find them a bit of a hassle, and the unpredictability was a non-issue because they were very unpredictable anyway) and lighter - my periods had been fairly heavy, and became medium-to-light.

Cons: Each time I had an old implant removed, it became harder for the healthcare provider to remove it: my body had formed some tough scar tissue around the implant, and they had to spend some considerable time tugging away to get it out. I had no pain because of the local anaesthetic, but it did feel peculiar and unpleasant. (There's no indication, visually or by touch, of the scar tissue from the outside of my body). I do have a small number of small white line scars on my arm from insertions and removals, but you'd have to really be looking there to notice them. For 24 hours after insertions/removals, I had a bandage around my arm, and (in summer) took care to cover up to avoid nosy people's questions. None of those were a remotely big deal, and certainly wouldn't put me off choosing the method again (although we might have to start using my other arm ).

My periods did become longer. That didn't bother me most of the time I was using it, because before I started, my periods were already a week long and my cycle tended to the short side, so a 9-12 day period once every three months was a great trade-in. Shortly before I stopped using it, they became 9-12 days every month, and that was no longer a good trade at all (especially when now, minus hormonal contraception, they're 4-5 days). When I wanted it removed, due to a change in personal circumstances ("I don't need it any more and cannot imagine needing it in the next year at least" - I was right), I had to wait for an appointment, and the healthcare provider I saw was unhappy about removing it because it was a long time before removal was due; they did remove it because I was firm about what I wanted, but it was upsetting for me, and I panicked at the time because I was entirely dependent on a healthcare provider for me to be able to stop using it. I probably got unlucky with that particular person.

Ease of use: I had to make an appointment and show up to that appointment, once every three years, and then go for a check-up around six weeks later. Not every doctor is trained in inserting these, so it had to be at an appropriate clinic, and there were limited appointment times available for the suitable healthcare provider. It does involve having a very small tube inserted below the skin, and not everyone would be a fan of that idea; but practically, apart from 30 minutes' time (and the tugging for removal), it really wasn't a big deal. I just ignored what someone was doing to my arm for 30 minutes, and then could entirely forget the implant and any concern about pregnancy for a whole 3 years. To me, that's almost the definition of "easy". It was free for me because I was in the UK, and contraception is free from the NHS.

Effectiveness: I did not become pregnant while using this method (and nor would I expect to, frankly). I did get it replaced when I was supposed to. For considerable amounts of time during the 6+ years I was using this method, I was having regular vagina-penis intercourse without any other contraceptive method.

Extra thoughts: I know my "con" section here is maybe the longest, but for perspective, while I was using this method (until the long monthly periods at the end) I was a big, big fan. The Pros gigantically outweighed the Cons, I needed a method and this was the stand-out one that was everything I needed and nothing I didn't want. I don't use this method now because my circumstances remain changed (although in a different way to the original change), but if I decide I want/need an almost-sure-thing and/or long-acting method again, this one will be right at the top of my list to consider, and I can't imagine choosing something else instead.