From the Guidelines
The contraceptive implant (Nexplanon/Implanon) is not recommended for emergency contraception due to insufficient evidence supporting its use for preventing pregnancy after unprotected intercourse. For emergency contraception, established options include oral levonorgestrel (Plan B, 1.5mg as a single dose within 72 hours of unprotected sex), ulipristal acetate (Ella, 30mg as a single dose within 120 hours), or the copper IUD (ParaGard, inserted within 120 hours) 1. While the contraceptive implant is highly effective for ongoing contraception once inserted (99% effective for up to 3-5 years), it works primarily by preventing ovulation and thickening cervical mucus to block sperm. However, it requires time to establish these effects, making it unsuitable for emergency situations. If a patient is interested in long-term contraception following emergency contraception, the implant could be placed after confirming the emergency method was effective and pregnancy has been ruled out.
Some key points to consider:
- The copper IUD is the most effective emergency contraception method, with a failure rate of less than 1% 1.
- Ulipristal acetate may have greater effectiveness than oral levonorgestrel at the end of the 5-day window of use, and its remaining effectiveness and adverse effect profile are similar to those of levonorgestrel 1.
- The contraceptive implant is a highly effective method for ongoing contraception, but it is not recommended for emergency contraception due to the lack of evidence supporting its use in this context 1.
In terms of patient counseling, it is essential to inform patients that the contraceptive implant is not suitable for emergency contraception and that other options are available. Patients should be counseled on the effectiveness and potential side effects of each emergency contraception method and helped to choose the best option for their individual needs. Additionally, patients who are interested in long-term contraception should be informed that the implant can be placed after confirming the emergency method was effective and pregnancy has been ruled out 1.
From the Research
Contraceptive Implant for Emergency Contraception
- The provided studies do not directly discuss the use of the contraceptive implant for emergency contraception 2, 3, 4.
- However, the studies mention that the most effective method of emergency contraception is the copper intrauterine device (IUD), which can be left in place for up to 10 years for long-term primary contraception 2, 3, 4.
- The contraceptive implant, such as Nexplanon, is a long-acting reversible contraception method that exerts its effects primarily by suppressing ovulation 5, 6.
- There is no evidence in the provided studies to suggest that the contraceptive implant is used for emergency contraception, but rather as a long-term contraception method 5, 6.
- The studies emphasize the importance of increasing awareness and knowledge of emergency contraception methods, including emergency contraceptive pills and the copper IUD, among healthcare providers and patients 2, 3, 4.