The contraceptive implant (Nexplanon) is a small flexible plastic rod that's placed under the skin in your upper arm by a doctor or nurse.

It releases the hormone progestogen into your bloodstream to prevent pregnancy and lasts for 3 years.

• The implant is more than 99% effective.
• Once the implant is in place, you don't have to think about it again for 3 years.
• It can be useful for women who can't use contraception that contains oestrogen.
• It's very useful for women who find it difficult to remember to take a pill at the same time every day.
• The implant can be taken out if you have side effects.
• You can have it removed at any time, and your natural fertility will return very quickly.
• When it's first put in, you may feel some bruising, tenderness or swelling around the implant.
• Your periods may become irregular, lighter, heavier or longer.
• A common side effect is that your periods stop (amenorrhoea). It's not harmful, but you may want to consider this before deciding to have an implant.
• Some medicines can make the implant less effective.
• It doesn't protect against sexually transmitted infections (STIs), so you may need to use condoms as well.

The implant steadily releases the hormone progestogen into your bloodstream, which prevents the release of an egg each month (ovulation).

It also thickens the cervical mucus, which makes it more difficult for sperm to move through the cervix, and thins the lining of the womb so a fertilised egg is less likely to implant itself.

When it starts to work

You can have the implant put in at any time during your menstrual cycle, as long as you're not pregnant.

If the implant is fitted during the first 5 days of your menstrual cycle, you'll be immediately protected against becoming pregnant.

If it's fitted on any other day of your menstrual cycle, you'll need to use additional contraception (such as condoms) for 7 days.

After giving birth

You can have the implant fitted any time after you've given birth.

If it's fitted before day 21 after the birth, you'll be immediately protected against becoming pregnant.

If it's fitted on or after day 21, you'll need to use additional contraception (such as condoms) for the next 7 days.

It's safe to use the implant while you're breastfeeding.

After a miscarriage or abortion

The implant can be fitted immediately after a miscarriage or an abortion and you'll be protected against pregnancy straight away.

A local anaesthetic is used to numb the area on the inside of your upper arm.

The implant is then inserted under your skin – it only takes a few minutes to put in and feels like having an injection. You won’t need any stitches after your implant has been fitted.

Nexplanon works for 3 years before it needs to be replaced. You can use this method until you reach the menopause, when a woman's monthly periods stop naturally.

The implant can be removed at any time by a specially trained doctor or nurse. It only takes a few minutes to remove, and a local anaesthetic will be used. The doctor or nurse will make a tiny cut in your skin to gently pull the implant out.

As soon as the implant has been removed, you'll no longer be protected against pregnancy.

Most women can be fitted with the contraceptive implant.

It may not be suitable if you:

• think you might be pregnant
• don't want your periods to change
• take other medicines that may affect the implant
• have unexplained bleeding in between periods or after sex
• have arterial disease or a history of heart disease or stroke
• have liver disease
• have breast cancer or have had it in the past
• have a medical condition that may affect which contraception you can use – speak to your GP or practice nurse, or visit your nearest sexual health clinic to discuss further

Advantages:

• it works for 3 years
• it doesn't interrupt sex
• it's an option if you can't use oestrogen-based contraception, such as the combined contraceptive pill, contraceptive patch or vaginal ring
• it's safe to use while you're breastfeeding
• your fertility will return to normal as soon as the implant is taken out
• it may reduce heavy periods or period pain

Disadvantages:

• you may experience temporary side effects during the first few months, like headaches, nausea, breast tenderness and mood swings
• your periods may be irregular or stop altogether
• you may get acne or your acne might get worse
• you'll need a small procedure to have it fitted and removed
• it doesn't protect you against sexually transmitted infections (STIs), so you may need to use additional contraception (such as condoms) as well

Some medicines can make the implant less effective, such as:

• medicines for HIV, epilepsy and tuberculosis
• complementary remedies, such as St John's Wort
• some antibiotics, such as rifabutin or rifampicin

If you're taking any of these medicines, you'll need additional contraception (such as condoms), or you may wish to use a different method of contraception that isn't affected by your medicine.

Always tell your doctor that you're using an implant if you're prescribed any medicine. You can also ask them whether the medicine you're taking will affect the implant.

In rare cases, the area of skin where the implant has been fitted can become infected. If this happens, you may need antibiotics.

You should also see a GP or healthcare professional at any time if:

• you can't feel the implant
• the implant feels like it's changed shape
• you notice any changes to the skin or feel any pain at the site of the implant
• you become pregnant

You can get the contraceptive implant for free, even if you're under 16, from:

• contraception clinics
• sexual health or genitourinary medicine (GUM) clinics
• GP surgeries
• some young people's services

Some (but not all) GPs or practice nurses are able to fit and remove implants, so you'll need to check at your GP surgery.

Alternatively, most sexual health clinics will be able to do this for you.

Find a sexual health clinic

Contraception services are free and confidential, including for people under the age of 16.

If you're under 16 and want contraception, the doctor, nurse or pharmacist won't tell your parents (or carer) as long as they believe you fully understand the information you're given, and your decisions.

Doctors and nurses work under strict guidelines when dealing with people under 16. They'll encourage you to consider telling your parents, but they won't make you.

The only time a professional might want to tell someone else is if they believe you're at risk of harm, such as abuse. The risk would need to be serious, and they would usually discuss this with you first.