Warning

Timing of insertion of subdermal implant

Women having Menstrual Cycles

  • An implant can be inserted up to and including day 5 of cycle without additional contraceptive precautions.
  • An implant can be inserted after day 5 if reasonably certain the woman is not pregnant. See Criteria for Reasonably Excluding Pregnancy

A careful history should be taken to ensure that the women has not had unprotected intercourse since last menses and has been correctly and consistently using a reliable method of contraception. Additional contraceptive precautions should be used for 7 days.

 

Women who are amenorrhoeic

An implant can be inserted at any time if reasonably certain the woman is not pregnant. Additional contraceptive precautions should be used for 7 days.

Following abortion or miscarriage

  • If inserted within 5 days of surgical or second part of a medical abortion - no additional precautions required.
  • If started beyond 5 days after event then 7 days of additional contraceptive precautions is required.

 

Postpartum

  • If inserted up to day 21, no additional contraceptive cover is required.
  • If started on or after day 21, 7 days of additional contraceptive precautions is required.

 

Switching from another method

Ensure adequate contraceptive cover from previous method continues for 7 days post insertion of implant.

After emergency contraception

  • Following ellaOne, an implant should not be inserted for 5 days, thereafter it can be inserted with additional contraceptive cover required for a further 7 days.
  • Following Levonelle, an implant can be inserted immediately with additional contraceptive cover required for 7 days.

Documentation

Procedures should only be undertaken by staff with appropriate training

  • Complete and update the full visit history as required.
  • Give written method information including contact number to client.
  • Record prescription.
  • Record site of implant, batch number and expiry date of medication.
  • Record implant site and date due for removal given to client
  • Record that the implant is palpated in situ post insertion
  • Nurse supplying where appropriate under patient group direction.
  • Notify GP of prescription, if permission is given for correspondence.

Editorial Information

Last reviewed: 31/05/2024

Next review date: 31/05/2026

Author(s): West of Scotland Managed Clinical Network for Sexual Health Clinical Guidelines Group .

Version: 9.1

Approved By: West of Scotland Managed Clinical Network for Sexual Health