Contraceptive implants and menstruation: what are the effects after insertion?

What are the consequences and risks of the contraceptive implant on menstruation? Will I stop bleeding if I have one? Today we answer your questions about its use!

What is a contraceptive implant?

The hormonal or contraceptive implant is a small, match-like piece of plastic, 2 cm in diameter and 4 cm long, which is injected under the skin to deliver hormones (etonogestrel) to block ovulation. The subcutaneous implant, like NEXPLANON in France, acts like the progestin-only pill, but releases hormones directly into the bloodstream for around 3 years. For one in five women, its use will stop menstruation and cause amenorrhea. In most cases, therefore, this method will have an effect on the combination of contraception and menstruation.

What effect does a contraceptive implant have on menstruation?

Like all hormonal contraception, the implant may have an impact on blood loss. Many women wonder whether they'll experience weight gain, acne, heavier flow with the implant or, on the contrary, no periods at all. 50 to 60% of women with implants have regular periods or periods less frequently than during their natural cycle. The menstrual period can be very short, or sometimes much longer, lasting around ten days.

Complete cessation of menstruation

On average, between 20% and 30% of women experience no blood loss at all for the duration of implant use. This side effect demonstrates the implant's effectiveness. It stops ovulation and reduces the thickness of the endometrium, which no longer bleeds. Once you've observed that the implant causes the absence of menstruation, there's no need to take a pregnancy test to check whether you're at risk of becoming pregnant every month.

In fact, it's a reliable contraceptive method, with close to 100% efficacy when administered between the 1st and 5th day of menstruation. Bear in mind that, in the case of amenorrhea, the implant is said to reproduce thehormonal state of pregnancy, and users may experience swelling or tension in their breasts during the first few weeks of use. Don't hesitate to speak to your healthcare professional if you have any questions or doubts.

The appearance of irregular periods

10 to 20% of implant users experience very frequent bleeding in the first six months after insertion under the skin. The flow is generally light, but spotting and blood loss are more frequent and prolonged.

This spotting is linked to the thinness of the endometrium of the uterine wall, which is thinned by the hormones. The endometrium is more fragile and tends to bleed more easily.

If you experience frequent bleeding and spotting with an implant, don't hesitate to consult your doctor. There are generally two possible solutions or medications

  • A course ofibuprofen prescribed for a few days, which will permanently stop spotting and bleeding outside the menstrual period.
  • Acourse ofestrogens to thicken the endometrium and prevent bleeding. The disadvantage is that this involves taking the pill!

When does the contraceptive implant start to affect menstruation?

The implant will have an impact on menstrual cycles from the moment it is inserted, with lasting consequences after 6 months. The effect on contraception will be immediate one day after the break, unless the implant is inserted after the 5th day of menstruation. Once menstruation has stopped, users will be able to observe amenorrhea at 28 days after insertion in the arm, the onset of their menstrual periods. It takes an average of three to 6 months for the implant's impact on the menstrual cycle to become definitive.

What are the alternatives to the contraceptive implant?

You have a choice of contraceptives to block pregnancy or regulate your menstrual cycle and flow. If you wish to remove your prescribed implant, here is a non-exhaustive list of alternatives that your healthcare professional, doctor or gynecologist can suggest.

Estrogen-progestin contraception Contraceptive with progestin Non-hormonal contraceptives
Effects: Block ovulation and cause lighter periods Effects: Blocks ovulation and menstrual cycle with false periods Effects: Does not block menstrual cycle and blood flow

The low-dose or combined pill

Progestin-only pill Copper coil

Contraceptive patch

Contraceptive implant Spermicides

Contraceptive ring

Hormonal IUD Condoms

Hormonal contraceptives Cervical cap diaphragm

In conclusion, the contraceptive implant is an effective and practical method of contraception for many women. Once inserted under the skin of the arm by a doctor or gynecologist, the implant continuously delivers a contraceptive hormone, etonogestrel, which blocks ovulation and prevents pregnancy. The implant is generally inserted in the arm after a local anaesthetic to minimize discomfort for the patient. This is done using a special applicator, avoiding the need for a surgical incision. Once in place, the implant acts like a contraceptive card, offering protection against pregnancy for several years. Women who choose this contraceptive method also benefit from a reduced risk of unplanned pregnancy, without having to worry about taking daily contraceptive pills or regularly changing the patch. However, as with any medication, side effects may occur, although these are generally mild and temporary. It is important that women considering the use of contraceptive implants receive full information from their doctor or gynecologist in order to make an informed decision about their contraception.

FAQs on contraceptive implants and menstruation

How does the contraceptive implant affect menstruation?

The implant is a hormonal contraceptive method that will have an impact on menstruation. It blocks ovulation and reduces endometrial production, which is responsible for blood loss. It blocks ovulation and thins the uterine wall. The flow will be shorter and less abundant. Some women will no longer menstruate, while others will experience spotting.

Should I remove my contraceptive implant if I have irregular periods?

In the event of irregular periods or spotting with an implant, it is not necessary to remove it in the first instance. Your doctor or healthcare professional will suggest alternatives to strengthen your endometrium and reduce its undesirable consequences. Whatever happens, it's important to report any side effects to them.

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