Everything You Need To Know About Sub-Dermal Implants | Contraceptive Choices

As a family planning doctor, I am in the privileged position to educate others about the different forms of birth control that are available.

In today’s story I discuss the sub-dermal implant which is known as a form of Long-Acting Reversible Contraceptive (LARC).

Sub-Dermal Implants

In Australia, there is currently one sub-dermal implant that is licensed for contraceptive use, known as Implanon NXT manufactured by the pharmaceutical company MSD.

It is comprised of a thin, flexible piece of plastic that is inserted under the skin’s surface by a specially trained health practitioner. It is a contraceptive option that is suitable for most women and lasts up to 3 years.

How Does It Work?

The Implanon NXT continuously releases a hormone, known as etonogestrel which has similar effects to the hormone found naturally in our body known as progesterone. It works as a contraception in two ways. Firstly, it prevents the release of an egg from the ovaries and secondly, it changes the mucus in the cervix (neck of the womb) making it difficult for sperm to enter.

Worldwide there are other brands of sub-dermal implant and these include Norplant, Jadelle and Nexplanon.

Who Should Not Use it?

Suitability will be assessed by your practitioner on an individual basis but it should not be used on those who:

- are pregnant or think they may be

- have a blood clot

- have or have had jaundice (skin yellowing)

- have severe liver disease or liver tumours

- have unexplained vaginal bleeding

- have or are thought to have cancer of the breast, ovary, womb or genital organs

- are allergic to any of the components within the implant.

There are also certain medications which may stop the implant from working well and your medical doctor will be able to advise you of these and offer an alternative method of contraception.

The Procedure

It is vital that if you are considering such a treatment that you seek an accredited medical practitioner as this is not a routine procedure. This procedure carries risks and practitioners must be specially trained to perform the procedure. Usually, they will have additional certification if they are a General Practitioner. For example, I myself have a diploma from the Faculty of Sexual and Reproductive Health which means that I have sat additional exams and have been assessed for the insertion and removal of contraceptive devices. If you are uncertain about your practitioner’s qualifications, you have every right to ask them. Specialist Nurses with additional training and accreditation can also perform the treatment. Aside from this you may wish to see a Gynaecologist who is a specialist doctor that has spent many years and sat several exams within the specialty of women’s health. Often, if a General Practitioner has some difficulties with insertion or removal, they may refer patients to a Gynaecologist.

Your practitioner will advise you on the best time to have the implant inserted and when you can rely on it for contraception. The practitioner will use a local anaesthetic to numb the area and insert the implant under the skin. A dressing will then be applied with a bandage.

Will You Feel It?

The implant is unlikely to be seen, however, you should be able to feel it gently with your fingers. It is important to not play with the implant as it may move away from the site of insertion making removal difficult. If you cannot feel your implant at any time, it is essential to use another form of contraception and seek medical advice.

Side Effects

As with any hormonal contraception there are side effects that you should be aware of and your medical doctor will go through these with you at length. These include a change in your bleeding pattern which could either be no bleeding at all, some bleeding as often or as less than normal or prolonged and frequent bleeding. Other side effects to be aware of include, acne, breast pain, headache, weight gain and mood changes. It is important to note that the sub-dermal implants do not protect you for sexually transmitted infections, therefor you should always practise safe sex.


The sub-dermal implant may be removed at any time, but no later than the 3 years after insertion. Removal is performed by a trained healthcare professional who will numb the area and make a small incision into the skin and remove the implant, as such you will have a small scar. You may wish to replace it with a new implant or remove it entirely at this point. If the implant is inserted too deeply and cannot be felt, you may be referred to a specialist doctor who will be able to remove this for you.

I hope that you have found this article helpful.

Take care and stay healthy,

Dr Nora x

Please note that the contents of this article are not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or medical condition.

Welcome to my clinic, featuring posts on General Practice, Minor Surgery, Cosmetic Procedures (incl. Anti-Wrinkle & Dermal Fillers), and Family Planning.

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