Thank you for your contact and please accept my sincere apologies for the delayed reply to your query, I do hope this has not inconvenienced you.

You asked about removing the Jadelle rods earlier than the 5 year recommended period. I would not recommend this for two reasons:

1. Medications should always be used according to the instructions for maximum effectiveness and Jadelle is designed to release controlled measured doses of levonorgestrel into your body continuously over a fixed period of 5 years with perfectly reliable pregnancy protection. There is a pregnancy risk of 0.8% in the first years increasing slightly to 1.1% over 5 years, which is similar to sterilization.

2. You are obviously concerned about getting pregnant if you leave Jadelle in place for 5 years. Do NOT worry about this. Your body adjusts to its new hormone balance and removing Jadelle within 12 months will achieve no benefit and could actually ‘mess around’ with your bleeding pattern and hormone balance because you are not giving your body time to ‘settle’ down

Remember though that Jadelle does not protect you against STI’s and fertility rapidly returns following removal of Jadelle.

Please explain this to your friends who are intent on replacing Jadelle after 1 yr. and if you are still anxious, talk to a doctor again about your anxiety as this will stress your body – not good.

I wish you all the best Babey, now relax and enjoy your love life!

Kind regards Carole

Hi Michelle,

Thank you for your email asking about the implant and bleeding sign/situation that is worrying you. I am a ‘reviewer’ not a doctor and therefore cannot give you ‘advice’ (just some information) which is wimping out of helping you I know but it sounds as though you know your body well in relation to its responses to your implant/hormone regime and I commend you for taking responsibility to get this checked out in as many avenues as you can.

First of all, irregular bleeding CAN be a side effect of an implant and is the main reason for women changing away from this popular form of BC so I am confident that it is a combination of things with you and nothing to really worry about.

HOWEVER, if YOU think your bleeding is abnormal and it’s obviously causing you anxiety then you MUST seek professional help as soon as possible- if only for reassurance to rule out any other cause (better safe than sorry) or to find a more appropriate method of BC to suit you and you partner.

Bear in mind, that as we age our body ‘s metabolism alters, which in turn, can affect the way we react to medications. Implanon is usually replaced after 3yrs as you know but 2 yrs is fine too in certain cases - 1 year is not usual if you were thinking that you need another one because of your weight.*

These facts may help you understand your specific status a bit better if you are obese:

• Obese women (BMI of 30 or higher) have lower fertility than other women but its not zero - Are you over BMI 40?
• Are you using Implanon? Obese women very likely have a higher risk of failure with oral contraceptives but the absolute risk is still modest and with Implanon or an IUD, you have probably chosen (or been advised) the better BC option
• Obese women have a lower level of etonogestrel (the active ingredient in Implanon) in their blood than other women
• *Implanon reduces its dosage of etonogestrel gradually over a 3 year period – since the concentration of etonogestrel is related to body weight, I wonder if a ‘dilution’ effect is occurring more rapidly in you -hence the irregular bleeding? This could indicate that over time (8 years in your case?) Implanonhas become less effective/less ideal for you and you may be wise to consider another form of BC.

In women of average weight, an implant should give at least 3 years protection before needing replacement.
You say you are on your 3rd implant in 8 years which is pretty good, given you say you are overweight but if you have continued to gain weight over 8 years I would suggest a thorough ‘overhaul’ of your contraceptive career is due to make sure that you are getting a method that is as effective as it can be.

Other options for BC which you’ve probably already thought about:

Depo Provera shot is an option that may also have been offered to you but is not as ‘convenient’ or long lasting as an implant. If the progestin implant is not acting well for you now it’s unlikely that the progestin shot (or the progestin IUD) will either so a combination estrogen/progestin may be the only alternative IF you can tolerate synthetic estrogen.

Essure or Vasectomy is always a future discussion point too if you have completed or don’t want a family. How does your partner feel about using condoms?

There’s a little more info on obesity and the pill on another post

So I wish you all the best Michelle, sorry I could not be more help, in spite of this, ‘get it sorted’ as they say in the UK and don’t let this worry spoil a great sexy and loving Christmas for you and your partner!

Kind regards Carole

Dear Michael, (a POM after my own heart?)

May I commend you on helping your girlfriend so responsibly by asking this question.

The fact is that if Implanon is not removed AFTER its expired 3 year period, infertility, ectopic pregnacy or an inability to halt a drug related adverse event may occur.

Implanon (progestin only) is 99% effective in preventing pregnancy for 3 years - after which it should be removed. If continued contraception is required after this period a second rod may be inserted straight away.

Tell your girlfriend that some women fall pregnant very quickly (within days) after Implanon is removed!
Best of luck Michael and thank you for using my site. There is a video on Implanon insertion/removal on here if you haven’t already seen it.

Hello Tatiana,

Your doctor should have told you when to remove the initial dressing and when it’s OK to shower without it. Transpore is great for holding IVs in place but since I am not a doctor I suggest you phone your doctor and discuss your situation with him/her.

Your skin is a living organ that certainly needs to ‘breathe’ to heal properly and the tape may be delaying this process, however, if the insertion site is still open it means that bacteria can get in too so it’s important to take the appropriate steps to protect the site until it seals over. The fact that there is no pain and oozing augers well so I expect that the doctor will advise you to lightly cover the wound with gauze or similar breathable material for a couple of days then let Nature do it’s work. Good luck and thanks for asking the question. Kind regards Carole.

Hi Cerys,

Assuming that the doctor who will be doing the replacement is skilled, you may only feel a bit of pulling and tugging when the old implant is removed and the new one is put back in the same place (or in the opposite arm if there any issues with removal -which is rare) Sometimes a rod cannot be pushed easily to the ‘ exit doorway’ so a little more surgery is needed to ‘free it up’.

I am surprised to read that the initial implant was inserted without a local anaesthetic as this is not usual (and painful!) and a removal is also usually done using a local injection of anaesthetic under or beneath the rod to prevent displacing it. A tiny incision is made at one end of the rod which is then pushed towards the little opening in the skin. The end of the rod is grasped with forceps/tweezers and then pulled out. If the rod cannot be ‘felt’ and it appears that the doctor is having trouble, I suggest that you ask for it to be located by ultrasound or MRI. I don’t want to alarm you, just inform you but blind attempts to remove an implant that cannot easily be felt and pushed to an exit wound may lead to scarring or worse damage.

I am confident that all will progress smoothly for you Cerys but you are wise to educate yourself in these procedures. Good luck, Kind regards Carole.

Dear Carole, It can take a while for an old implant site to ‘to settle down’ after removal, especially if the removal was a bit tricky or pulled/tugged a lot, causing bruising. The lump you are feeling could be due to a bit of internal scar tissue that grew around the old implant over the years. Hopefully the doctor was skilled in removing your old implant and has also scheduled you for a 3 month check up following the new insertion. At this consult mention your concern to him IF the old site has not ’subsided’ to your satisfaction.

Occasionally some women do have scarring but as someone who has a larger than necessary laporoscopy scar, I often wonder if this is dependent on the skill of the doctor rather than the healing capacity of one’s body! You can check how well your implant was inserted/removed by comparing the procedures to these two in these videos on my main website. Post is titled “Low Dose Birth Control or LARC?” (you will need to scroll down on the page a bit) I wish you all the best Carole. Thank you for your query and please let me know if you acquire further feedback on your problem so that we can post it on my website too in case it helps others.

Dear Brogan,

Your doctor should have scheduled you for a 3 month check up after insertion of your implant so it is difficult for me to assess how far below the skin the rod has been inserted. Normally you can FEEL its shape/outline when you press on top of the site not see it. The scar should fade (Vit C helps healing) although some women DO experience a little scarring. The fact that you have no redness, swelling, pain or itchiness is excellent but it would be irresponsible of me to hazard any further thoughts. You need to put your mind at rest and get it checked it out now. Is there a family planning clinic near you for a second opinion? Best wishes, Carole

Hi Katy, Thanks for this query which I am sure will help others. After 5 days you should be fine to shower as normal- look closely at your ‘wound site’ - it should look nicely sealed..

After insertion, an implant should be kept dry and ‘protected’ from bumping for at least 24 hrs after which any bandage may be removed. Underneath is often a plaster/band aid covering the small wound which is susceptible to infection if it is not kept dry for at least another 3 days. Showering can be tricky during the first few days after insertion so make sure that water does not hit the dressing on the wound site directly and certainly pat dry to be extra sure.

Go straight to your doctor if your arm goes red or the site ‘oozes’ as this may indicate an infection. A little swelling and soreness is normal during the first 24 hrs.

The contraceptive implant is a highly effective method of birth control as I’m sure you know so you have chosen a method of contraception that will last for years. Implants don’t protect against STIs but you know that too right?

Hello Jess, Thank you for your query. Firstly, you need to alay your pregnancy anxiety as this won’t help- people often feel sick just with nerves so confirm with another pregnancy test if it hasn’t already been ruled out. Secondly, remember that when you start to take (or change) any type of hormonal birth control it ‘tricks’ your body into thinking it is pregnant so your initial side effects sound normal to me and hopefully by now your metabolism should be rebalancing itself and the symptoms subsiding. 10% of women experience nausea initially and it looks as though you’ve drawn the short straw here Jess! The more common side effects with Jadelle are bleeding irregularities, weight gain and sometimes depression, hopefully none of these will affect you though. Jadelle gives you protection from pregnancy within 24 hrs if inserted in the first week of your menstrual cycle. In some women it can up to 3 months for their body to adjust to a change in hormone levels.

Jadelle contains no estrogen, just progestin and is one of the better options for temporary, long term and easily reversible contraception. Jadelle is effective for women of varying weights but I assume that you have discussed your medical history with your doctor to ensure that you have no contraindications for using this form of birth control? I advise you not to smoke of course and I suggest that you keep up to date with your blood pressure checks.
Removal of an implant is advised as the 5 year term approaches, which I’m sure your doctor has told you. Enjoy a confident and relaxed loving relationship with your partner Jess. One last thing I must remind you-
you’ll know that there is no protection from STIs included in the benefits of any implant. It doesn’t sound as though this is relevant your relationship. Best wishes Carole

Hello Dan, Thank you for your question. The short answer is that an implant is one of the most effective, long term forms of birth control and will provide several years (3-5 depending on type) of birth control without the use of additional barriers like condoms BUT if your partner is taking ANY medications for seizures, tuberculosis or other illnesses, they may reduce the effectiveness of the hormone which is being delivered via the implant so make sure this is checked with a doctor (I assume this will have been covered already before the implant was put in though?).

The risk of failure in the first year of use is 0.05% (i.e., for every 2,000 women using implants, 1,999 do not become pregnant in the first year).

Once an implant is removed a woman’s ability to become pregnant returns quickly. You do not say if you already have children but if your partner is breast feeding, the hormone in the implant will not interfere with milk production.

I always suggest that condoms are used for added protection against sexually transmitted diseases but this is a personal matter for mutual discussion with your partner.