Role Of Hormonal Implants In Birth Control
Birth control has played a transformative role in reproductive health, allowing individuals to plan and space pregnancies based on personal and medical considerations. Among the many contraceptive options available today, hormonal implants stand out as one of the most effective and long-lasting methods. These small, flexible rods are inserted under the skin and continuously release synthetic hormones that prevent pregnancy for several years.
Hormonal implants provide a high level of protection against unintended pregnancies, are easy to use, and require minimal maintenance compared to other birth control methods. With an efficacy rate of over 99%, they are one of the most reliable contraceptive solutions available. However, like all medical interventions, hormonal implants come with their own set of benefits, risks, and considerations that must be understood before making an informed choice.
This detailed and comprehensive guide will explore the role of hormonal implant in birth control, explaining how they work, their advantages, potential side effects, and comparisons with other contraceptive methods. We will also discuss factors that determine their effectiveness, their cost, and accessibility worldwide, and address some of the most frequently asked questions about hormonal implants.
Understanding Hormonal Implants

What Are Hormonal Implants?
Hormonal implants are small, matchstick-sized rods made of medical-grade plastic that are inserted subdermally in the inner upper arm. They gradually release progestin, a hormone similar to progesterone, which plays a crucial role in regulating the menstrual cycle and preventing ovulation.
Types of Hormonal Implants
The most commonly used hormonal implant is Nexplanon (previously known as Implanon). Nexplanon contains etonogestrel, a type of progestin, and is designed to last up to three years. Other implants, such as Sino-implant (II) and Jadelle, are also available in certain regions, offering similar benefits.
How Do Hormonal Implants Work?

Suppression of Ovulation
The primary function of hormonal implant is to prevent ovulation, which means no egg is released from the ovaries. Without ovulation, fertilization cannot occur.
Thickening of Cervical Mucus
The progestin released by the implant thickens the cervical mucus, making it difficult for sperm to reach an egg if ovulation does occur. This serves as a secondary layer of protection.
Thinning of the Uterine Lining
Hormonal implant also cause the lining of the uterus (endometrium) to become thinner, reducing the chances of implantation if fertilization were to happen.
Effectiveness of Hormonal Implants

High Success Rate
Hormonal implants boast a success rate of over 99%, making them one of the most effective birth control methods available. Only about 1 in 1,000 women using implants will become pregnant in a given year.
Comparison With Other Contraceptive Methods
- Birth Control Pills – While effective, pills require daily use, and missing a dose can reduce effectiveness.
- IUDs (Intrauterine Devices) – IUDs are also highly effective but involve a different mechanism and require insertion into the uterus.
- Condoms – While providing protection against STIs, condoms are only about 85% effective in preventing pregnancy with typical use.
Advantages of Hormonal Implants

Long-Lasting Protection
One of the most significant benefits of hormonal implants is their long duration of action—lasting up to three to five years, depending on the type. This eliminates the need for frequent doctor visits or daily pill reminders.
Convenience and Discreetness
Unlike other forms of contraception, hormonal implants are discreet and require no effort after insertion. There is no visible sign of the implant, making it a private birth control option.
Rapid Reversibility
Once removed, fertility typically returns quickly, with many women ovulating within a few weeks to months. This makes hormonal implants an excellent option for those who may want to conceive in the near future.
Safe for Breastfeeding Mothers
Progestin-only contraceptives, including implants, do not interfere with breast milk production, making them safe for breastfeeding women.
No Estrogen-Related Risks
Unlike combined birth control pills, hormonal implant do not contain estrogen, which is known to increase the risk of blood clots and other complications. This makes implants a safer option for women who cannot use estrogen-based contraceptives.
Disadvantages and Side Effects of Hormonal Implants

Irregular Menstrual Bleeding
Many women experience changes in their menstrual cycle, such as irregular bleeding, spotting, or even amenorrhea (absence of periods). These changes are generally harmless but can be bothersome.
Insertion and Removal Procedure
While the insertion procedure is minor and takes only a few minutes, it does require a healthcare provider. Some women may experience bruising, swelling, or pain at the insertion site.
Possible Side Effects
Some users report side effects, including:
- Headaches
- Breast tenderness
- Weight gain
- Mood swings
- Nausea
No Protection Against Sexually Transmitted Infections (STIs)
Unlike condoms, hormonal implants do not protect against STIs, so additional protective measures are recommended for those at risk.
Hormonal Implants vs. Other Contraceptive Methods
Contraceptive Method | Duration | Effectiveness | Maintenance | Hormonal? |
---|---|---|---|---|
Hormonal Implant | 3-5 years | >99% | Low | Yes (Progestin) |
Birth Control Pill | Daily | ~91% | High | Yes (Estrogen + Progestin) |
IUD (Hormonal) | 3-7 years | >99% | Low | Yes |
IUD (Copper) | 10+ years | >99% | Low | No |
Condoms | One-time use | ~85% | High | No |
Injectable (Depo-Provera) | 3 months | ~94% | Medium | Yes |
Who Can Use Hormonal Implants?

Hormonal implant are suitable for most women, including:
- Women who want long-term but reversible contraception
- Women who cannot use estrogen-based birth control
- Breastfeeding mothers
- Women seeking a low-maintenance contraceptive option
However, implants may not be suitable for women with:
- A history of blood clots
- Severe liver disease
- Unexplained vaginal bleeding
- Certain types of cancer (such as breast cancer)
The Insertion and Removal Process

Insertion Procedure
- A healthcare provider applies a local anesthetic to numb the upper arm.
- A special applicator is used to insert the implant just under the skin.
- The procedure takes only a few minutes and does not require stitches.
Removal Procedure
- The healthcare provider numbs the area.
- A small incision is made to remove the implant.
- The removal process may take slightly longer than insertion but is generally simple.
The Cost and Accessibility of Hormonal Implants
Cost Considerations
The cost of hormonal implants varies, ranging from $ to $, for insertion, but many insurance plans cover it. Removal costs may be separate, ranging from $ to $.
Global Availability
Hormonal implant are available in most countries, often through family planning clinics, government health programs, or private healthcare providers.
Addressing Common Myths About Hormonal Implants

Myth 1: Hormonal Implant Cause Infertility
Truth: Fertility returns rapidly after removal, and many women conceive within a few months.
Myth 2: They Make You Gain Weight
Truth: While some women report minor weight changes, studies show no significant long-term weight gain directly caused by implants.
Myth 3: They Are Painful
Truth: The insertion process is minimally painful due to the use of local anesthesia.
Future of Hormonal Implants
Research is ongoing to develop longer-lasting, more comfortable, and even more effective hormonal implants. Scientists are also working on biodegradable implants that do not require removal.
Q1. What exactly are hormonal implants?
Hormonal implants are small, flexible rods about the size of a matchstick that are inserted just beneath the skin of the upper arm, typically by a healthcare provider. These implants release progestin, a synthetic form of the hormone progesterone, into the body. Progestin mimics natural hormones in the body to prevent pregnancy in several key ways. The most commonly used hormonal implant on the market today is Nexplanon, though there are other similar devices available globally, each offering comparable contraceptive protection. Once inserted, hormonal implants provide long-term contraception for several years, with the most commonly used versions lasting up to three years. They are highly effective and considered a “set-it-and-forget-it” method of contraception, making them an appealing option for many women.
Q2. How do hormonal implants prevent pregnancy?
Hormonal implants prevent pregnancy in a highly effective and multifaceted way. Here’s how:
Inhibition of Ovulation: The most prominent mechanism of action is the prevention of ovulation. Ovulation is the process by which an egg is released from the ovary. The progestin in the implant inhibits this release, meaning no egg is available for fertilization by sperm. Without the egg being released, pregnancy cannot occur.
Thickening of Cervical Mucus: Progestin also thickens the mucus in the cervix. This creates a barrier that makes it much more difficult for sperm to travel through the cervix and reach the egg, even if ovulation were to occur.
Thinning of the Uterine Lining: The presence of progestin in the body causes the lining of the uterus (the endometrium) to become thinner and less hospitable. In the event that fertilization occurs, this thinner lining will make it more difficult for the embryo to implant and establish a pregnancy.
All of these factors combined make hormonal implants one of the most effective and reliable forms of contraception available. The primary benefit of these implants is their ability to work continuously over a long period of time, preventing pregnancy without the need for constant attention.
Q3. How effective are hormonal implants in preventing pregnancy?
Hormonal implants are considered one of the most effective contraceptive methods available, with a success rate of over 99%. This means that less than 1 in 1000 women will become pregnant while using hormonal implants in a year. The failure rate is so low because once the implant is properly placed under the skin, it releases a steady amount of progestin, effectively blocking ovulation and altering the cervical mucus. Even during typical use, which may include instances where a person forgets to get their implant checked or fails to maintain strict adherence to certain usage guidelines, hormonal implants still offer extraordinary protection.
In comparison, other common methods of birth control like birth control pills (91% effective with typical use) or condoms (85% effective) have significantly higher failure rates. The reliability of hormonal implants is a major selling point for many women who want to reduce the risk of unintended pregnancies.
Q4. How long do hormonal implants provide contraception?
Hormonal implants offer long-term protection against pregnancy. The most widely used implant, Nexplanon, provides continuous contraception for up to three years. However, some implants on the market can last even longer, offering up to five years of protection. The precise duration of effectiveness depends on the specific brand and type of implant used, as well as individual factors like how well the device is inserted and how the body responds to the hormone.
Once the implant expires, or if you no longer wish to use it, it can be easily removed, and fertility will generally return very quickly. If you want to continue contraception after the removal of the implant, a new implant can be inserted without any delay.
Q5. Who is an ideal candidate for hormonal implants?
Hormonal implants are suitable for most women who want an effective, long-term form of contraception. They are especially ideal for women who:
Have difficulty remembering to take a daily birth control pill or perform other regular actions for contraception.
Are looking for a long-lasting and convenient method of contraception that doesn’t require daily attention.
Cannot use estrogen-containing contraceptives due to health concerns such as a history of blood clots, migraines, or certain cancers.
Are breastfeeding and need a method of birth control that doesn’t interfere with milk production.
Want a reversible contraceptive method that allows them to plan for pregnancy when they’re ready.
However, hormonal implants may not be appropriate for women who:
Have a history of blood clots or certain cardiovascular conditions.
Are experiencing unexplained vaginal bleeding.
Have certain types of cancer, including breast cancer, or have a history of hormone-sensitive cancers.
It’s essential to discuss personal health factors with a healthcare provider before choosing an implant, as they can assess whether it’s the right choice for you.
Q6. What does the process of getting a hormonal implant involve?
Getting a hormonal implant involves a straightforward, minimally invasive procedure:
Consultation and Pre-Procedure Evaluation:
Before receiving the implant, you will meet with a healthcare provider to discuss your health history, any medical conditions you may have, and whether the implant is the right contraceptive method for you.
Insertion of the Implant:
A local anesthetic is applied to the skin of the upper arm where the implant will be inserted.
The implant is inserted just beneath the skin using a specialized applicator.
The procedure takes about 10 to 15 minutes, and it’s generally well-tolerated.
Post-Insertion Care:
After the implant is placed, you will be monitored for a short period to ensure there are no immediate complications. You may experience some bruising, swelling, or tenderness at the insertion site, but these symptoms usually resolve quickly.
9. What happens if I want to stop using the hormonal implant?
If you decide you no longer want to use the hormonal implant, you can have it removed at any time. The removal procedure is simple and similar to the insertion process:
Local Anesthesia: The area around the implant site will be numbed to ensure comfort.
Removal of the Implant: A small incision is made, and the implant is gently removed.
Post-Removal Care: The procedure typically takes 10 to 15 minutes. Some bruising or discomfort may occur at the site, but it’s generally temporary.
Once the implant is removed, fertility usually returns quickly, allowing you to conceive if desired. If you don’t wish to become pregnant, you can begin using another form of contraception immediately after the implant is removed.
Q7. Can I get pregnant while using a hormonal implant?
The chances of getting pregnant while using a hormonal implant are extremely low, with a failure rate of less than 1%. However, while highly effective, no contraceptive method is 100% foolproof. Pregnancy can occur if the implant is improperly inserted, if the implant moves out of place, or if it has passed its expiration date. If you suspect you may be pregnant or experience unusual symptoms, you should consult with a healthcare provider immediately and take a pregnancy test.