Contraceptive Implants: Periods, Bleeding & More

Introduction to Contraceptive Implants and Their Impact on Periods

The contraceptive implant works by releasing a hormone called progestin (a synthetic form of progesterone) into your bloodstream. This hormone prevents pregnancy by:

• Inhibiting ovulation: Preventing the release of eggs from the ovaries.
• Thickening cervical mucus: Making it more difficult for sperm to reach an egg.
• Thinning the uterine lining: Reducing the likelihood of implantation.

These hormonal changes often affect your menstrual cycle, and while this is an expected response, the unpredictability of changes can be unsettling. Understanding what is typical and when to seek help can make your experience with the implant smoother and more reassuring.

How Does the Contraceptive Implant Affect Your Periods?

Irregular Bleeding Patterns

Irregular bleeding is one of the most common side effects of the contraceptive implant. You may experience any or all of these:

• Frequent bleeding: More days of bleeding than usual, although often lighter than a regular period.
• Infrequent bleeding: Fewer bleeds or longer gaps between them.
• Prolonged bleeding: Bleeding that lasts longer than your typical period.
• Amenorrhea (no periods): Some people stop having bleeds altogether.

Research shows that:

• Around 20% of users experience no bleeding at all after one year.
• About 50% have infrequent or light bleeding.
• A smaller percentage report frequent or prolonged bleeding.

While irregular bleeding is harmless, it can be inconvenient and frustrating. It’s worth noting that these changes vary significantly between individuals and may settle over time.

Why Does Bleeding Change with the Implant?

A period is the result of a womb lining growing, no pregnancy implanted and then shed to begin the process again. We expect a lining to be shed 14 days after ovulation, if a pregnancy has not occurred and the hormone levels drop.
The implant contains progesterone, which when given continuously, interrupts the expected fluctuations of the usual cycle by:

• Suppressing Ovulation: Without ovulation, the hormonal signals that trigger regular menstruation are disrupted.
• Thinning the Uterine Lining: A thinner lining results in lighter bleeding or no bleeding at all.
• Hormonal Fluctuations: As your body adjusts to the implant, you may experience irregular bleeding until it stabilizes.

These changes are not harmful and do not indicate that the implant is ineffective. However, some bleeding patterns, such as prolonged heavy bleeding, can occasionally require medical investigation and discussion.

Managing Irregular Bleeding

While irregular bleeding often improves over time, there are ways to manage it if it becomes bothersome:

1. Over-the-Counter Pain Relief
If cramping accompanies bleeding, non-prescription painkillers like ibuprofen can provide relief.

2. Hormonal Treatments
Short-term use of combined hormonal contraception (like the pill or patch) alongside the implant can help regulate bleeding. This is usually done under medical supervision.

3. Non-Hormonal Medications
Tranexamic acid, a medication that reduces bleeding, can be prescribed for short-term use in cases of heavy or prolonged bleeding.

4. Tracking Your Bleeding
Keeping a record of your bleeding patterns can help us assess whether further management is needed.

5. Patience and Adjustment
In many cases, bleeding settles naturally within the first 3–6 months. It can be helpful to give your body time to adapt before seeking changes.

6. Using tampons or vaginal cups.
It can be beneficial to wear internal sanitary protection, as you don’t always see this bleeding every time you go to the bathroom, or comment that you are still bleeding. Psychologically, this can support the transition from a regular cycle to an irregular cycle.

Common Concerns Related to Bleeding

Is Irregular Bleeding a Sign That the Implant Isn’t Working?

No. Irregular bleeding does not mean the implant is less effective. The implant is over 99% effective at preventing pregnancy.

Will the Bleeding Stop Completely?

For some, periods stop altogether while using the implant, which is entirely safe. However, not everyone experiences this.

What if the Bleeding Is Heavy or Persistent?

While uncommon, some people may experience heavy or prolonged bleeding. If this affects your daily life, please get in touch with us so we can offer tailored advice or explore alternative options.

Other Hormonal Side Effects to Be Aware Of

In addition to changes in bleeding patterns, the implant may cause side effects such as:

• Mood Changes: Some users report mood swings or mild depression.
• Weight Fluctuations: While there is no clear evidence linking implants directly to weight gain, some individuals may notice changes.
• Skin Changes: Hormonal contraception can sometimes cause acne, although this is less common with the implant compared to other methods.
• Headaches: Some users report more or persistent headaches.

If these side effects persist or worsen, we encourage you to get in touch with us. We can discuss ways to manage these concerns and help you decide on the best course of action.

Switching or Removing the Implant

If irregular bleeding or other side effects persist and are unmanageable, you have options:

• Switching to another contraceptive method: We can help you explore alternatives, such as the intrauterine device (IUD), combined pill, or injection.
• Removing the implant: Removal is straightforward, and fertility typically returns quickly. If removal is necessary, we’ll ensure you have backup contraception to prevent an unintended pregnancy.

When to Seek Medical Advice

While irregular bleeding is typically harmless, it’s important to contact us if you experience:

• Extremely heavy bleeding requiring frequent pad or tampon changes.
• Bleeding accompanied by severe pain or discomfort.
• Changes in discharge, together with an increase in odour.
• Signs of infection at the implant site (e.g., redness, swelling, or pus).
• Inability to find both end of the implant in your arm.
• Any new or unusual symptoms causing concern.

Our team is here to help and can provide guidance, reassurance, and treatment if needed.

Concluding Remarks

The contraceptive implant is a highly effective and convenient form of contraception, but its impact on your periods can take some adjustment. Understanding that irregular bleeding is a common side effect – and knowing how to manage it—can make your experience more positive.

If you find that bleeding patterns or other side effects interfere with your quality of life, don’t hesitate to get in touch with us. We’re here to support you in finding a contraceptive method that works best for your needs, ensuring your reproductive health and overall well-being are prioritised.