In January 2020, I got the contraceptive implant. This was a big move for me, and it took a lot of deliberating to finally decide that I would try this form of contraception. There are some incredibly useful sources of information online that I used, as well as myriad opinions on and experiences of different methods of contraception. I wanted to add to that with my experience of contraception and periods.
I think it’s important for women to talk about contraception. It’s definitely a feminist issue, and women have historically been pressured into taking contraceptive medication, shamed for doing so, expected to do so, and expected to silently accept the repercussions of contraception on the body. The side effects are countless, and affect everyone differently. There is also the common conjecture that if any medication intended for men impacted their bodies so extremely and extensively as medical methods of contraception intended for women, they would not be prescribed, or even make it past the initial stages of testing.
It’s a huge debate that I certainly can’t tackle in one article. (But it is super interesting to research and talk about!) One thing I always find myself pushing against, though, is contraception and bodily autonomy. I shouldn’t be expected to take contraceptive medication – it is not a woman’s duty to do so. There should be medication for men that similarly prevents pregnancy. But there isn’t. I do not trust condoms (more on this later!), and, at present, I don’t want to get pregnant, so I am taking the steps to prevent it. However, contraception can be liberating and empowering because it puts the woman in control of her body. It’s not my duty to take it, it’s my choice.
I’m going to write this candidly, explaining why I wanted to go on contraceptive medication and how it has affected me. According to a 2019 report by The Guardian, the implant isn’t prescribed very frequently, and most women opt for the combined pill or the POP pill. So I also want to open the discussion on an alternative method of contraception: the implant.
Disclaimer: Contraception isn’t just used to prevent pregnancy, and I don’t think it should ever be considered in this capacity alone. Contraception can have major impacts on a woman’s body, and can be used for a range of reasons, whether it’s to reduce acne, stabilise hormones, or even treat other medical issues. One of my main reasons for using contraception is to do with my periods and hormones.
Another disclaimer: I am not anywhere close to qualified to talking on this. This is just my experience, a couple of opinions, and some useful resources.
I’m 19-years-old and I started my period when I was 12. My periods are heavy, painful and debilitating, and would frequently leave me feeling faint, light-headed and nauseated. I never wanted to experiment with contraceptive pills in case it made my periods heavier or more painful (a common side effect). I was also told that these symptoms would get less extreme as I got older.
Other side effects I was fearful of include: acne, weight gain, headaches and mood swings. I already experienced all of these things with general adolescence and hormones, and so I didn’t want to risk making any of it worse. In short, I believed that ‘common side effects’ meant ‘these things will happen’, which just isn’t true.
Contrary to what I was told, my periods never got lighter or less painful. When I started University, this became more of a problem. In school, the workload was much more manageable alongside monthly 3-day stints in bed loaded with painkillers. At uni, I just couldn’t manage my pain properly alongside my degree, and I would fall behind with my work. Supervisors were understanding, but that didn’t mitigate the fact that I was writing fewer essays at a lower quality. It was frustrating, and I started looking for a fix.
Mood swings were also a major issue for me, and with my period didn’t just come the usual moodiness but extreme bouts of frustration, anger and dark thoughts. ‘Period pain’ certainly isn’t just physical, and, in my search for a remedy, I was looking for something that would help to level or reduce both my physical and my mental afflictions.
Whilst I was at school, a common misconception was that you would start on the pill if you were sexually active. Note misconception: you do not need to be sexually active to use contraception. The majority of my desire to go on some form of medical contraception was for the reasons above: my god-awful period.
That’s not to say, though, that there isn’t the added benefit of contraception actually also preventing pregnancy. That feels reversed but, in reality, if my periods were less painful, I never would have started experimenting with medicinal contraception – for me, it just wouldn’t be worth it.
Before I started my search for medical contraception, I only used condoms, and condoms definitely aren’t perfect. One thing you’re not taught at school (or, at least, I wasn’t taught) is what to do when a condom breaks or slips off. This issue was addressed with ‘that’s rare – condoms are 98% effective’, or whatever teachers were told to tell us. The reality – with breakage, slippage, and human error taken into account – is that condoms are only actually 85% effective.
I would personally put condoms at about 75% effective – based on some quick mental maths on my own sexual encounters involving condoms. This is probably not completely accurate, but I’ve had quite a few slip-ups in my time. Maybe it’s me. Maybe it’s my sexual partners. Regardless, in short, I am keenly aware of the flaws in condoms, and using only condoms to avoid pregnancy.
When something goes wrong with your condom, the simple answer is to get the morning after pill. However, this is still a bit of a taboo activity: it’s something you have to pay for, it implies you were silly enough to forget a condom, you’re a bit of a burden on the NHS. But people get the morning after pill for a multitude of reasons, and the taboo means we don’t talk about the associated side effects enough. I’m going to talk briefly about it here.
Firstly, the morning after pill can be expensive, but there a lot of options on where to get it for free, including:
- some pharmacies
- sexual health/GUM clinics
- NHS walk-in centres and A&E departments
- your GP
- [find more info on the NHS website]
I was lucky enough to live close to a Boots pharmacy that offers the morning after pill free of charge after a short conversation with the pharmacist. The morning after pill is tiny, but it is absolutely loaded with hormones to prevent pregnancy. Like all medication, this inevitably has side effects.
The short list of side effects includes: headaches, nausea, changes to your period, and stomach cramps. However, you can also experience: pelvic pain, a rash, abdominal pain, swelling, breast tenderness, mood swings, unusual discharge, anxiety, migraines, exhaustion, trouble sleeping, acne, irritated skin, and more.
These do not happen – according to the NHS, Levonelle and EllaOne (the UK’s emergency contraception providers) – to most people. Anecdotally, everyone I know who has taken the morning after pill has experienced one or more of the extra side effects.
I won’t go into detail with my experience but, in short, it was bad. In the end, I had to go back to my GP to find out what was going on with my body, and go on two rounds of extra medication to fix it. I hope to never have to take the morning after pill again. Going onto proper, non-emergency contraception felt like a good idea.
Which contraception and why?
In the UK, there are quite a few choices on modes of contraception:
- The physical modes: condoms, femidoms, caps/diaphragms
- The combined pill
- The implant
- The injection
- The patch
- IUD (intrauterine device, also called the coil)
- IUS (intrauterine system, or hormonal coil)
- Progestogen-only pill (the POP)
- Vaginal ring
These all come with pros and cons, and the NHS website is a great resource for getting a brief summary of what each contraception involves and whether it would suit you.
Some options will be ruled out immediately. For example, I get migraines, which means I can’t take medication containing oestrogen (also spelled estrogen) as it increases the risk of having a stroke. The combined pill (the most common pill) contains oestrogen. Your doctor should ask about migraines (and other health factors) when deciding the best contraception for you.
Some options also just won’t appeal. I found the idea of a contraceptive mechanism placed directly in the vagina made me squirm. Other people don’t like injections or taking pills. After some extensive research and a chat with a lovely nurse at my GP, I decided on the contraceptive implant.
The contraceptive implant is a matchstick-size plastic tube inserted by a nurse into your upper arm (under anaesthetic). It lasts for 3 years before it needs to be taken out and replaced (if you want to carry on with it). It slowly releases progestogen into the bloodstream. More detailed medical information can be found on the NHS website.
For me, the major allure of the implant includes how:
- It’s 99% effective at preventing pregnancy
- It lasts for 3 years, so is relatively hassle free
- It doesn’t involve a daily pill, meaning human error isn’t a factor
- It usually makes periods lighter, and frequently stops periods entirely (very attractive with my extreme period pain)
- It’s oestrogen-free
I made this decision with my nurse in October 2019, and went on a trial run of the POP until January. The POP contains the same hormone as the implant, so is a simple, non-committal method to decide if progestogen medication is right for you. My nurse told me that many people find that the POP alone is good for them, because you can avoid the surgical placement of the implant and stop taking it at any time. However, I found taking a pill to make me quite nauseated in the morning, and I wasn’t really opposed to the surgical placement of the implant. After a catch-up with my nurse in December to run through any side-effects I was experiencing (more on this later), I booked my appointment to get the implant in January 2020.
Pros and cons
- My periods have almost entirely stopped. Sometimes I have light bleeding, but I haven’t experienced the level of bleeding I used to (that used to make me faint).
- Equally, my period pains have almost entirely stopped. Sometimes I get lower back pain, but not to the extent that I used to.
- My mood swings have levelled out considerably and are much less extreme than they used to be.
- After the initial insertion, you don’t have to think about it for three years.
- You’re protected from pregnancy if you have any condom blunders.
- The transition from POP to implant is pretty seamless. If anything, the implant reduced some of the side effects I was experiencing with the POP.
- It takes your body a few months to settle in to a new rhythm. This started when I was on the POP and only really settled down in March.
- It’s difficult to keep track of any discharge/bleeding that may occur, so you kind of always have to be prepared with a sanitary towel/tampon, but that’s quite easy if you’ve been having periods for a few years. (I’ve never had bleeding heavy enough for a tampon since the POP or the implant.)
- The surgery did make my arm feel a little strange for a couple of days. Totally manageable, but maybe not ideal if injections/blood makes you squeamish.
- It doesn’t protect you against STIs or STDs so condoms should still be used if you’re not 100% sure that either you or your partner is STI/STD-free.
- The scar: I have a dot on my arm where the implant was inserted, but it’s quite small and hidden.
- Removal: I haven’t been through this yet, so can’t comment, but it does involve an incision and another scar.
In conclusion, the POP and implant changed my life. I am liberated from my period pain and also the burden of potential pregnancy. Needs, preferences and side effects vary massively between people, but I hope this at least provides a little bit of insight into the implant, why you might get it, and how it works.