Contraception and its many different forms are a talking point for women across the country. With so many different types on the market, coupled with the fact that every woman’s body is different, we take a closer look at all the options that are available to you.  This week, we focus on the Bar or Contraceptive Implant. Last week, we explained all the basic facts you need to know about the pill: how it works, the best pill for you and most importantly, when the pill doesn’t work. Now, we take a closer look at the Contraceptive Implant. ______________________________________________________________________ Hold up – You actually want to put a metal bar in my arm? No, of course not!  The contraceptive implant is a flexible plastic rod (about the size of a matchstick) that is inserted under the skin.  There are different devices world-wide, but the only one available in Ireland is called the “Implanon NXT”. So, how does the doctor get it in? The Implant is put in to the inner side of your upper arm.  If you are right handed, normally it will be inserted into your left arm.  Getting the implant fitted requires you to have a small procedure done, where the doctor injects your skin with a little bit of local anaesthetic, after that, you shouldn’t feel anything (honest!).  It is then inserted under the skin of your upper arm on a needle.  The procedure usually takes 10-15 minutes. The contraceptive implant is about the size of a matchstick. When is the best time of the month to get it in? The doctor needs to be sure that you are not pregnant before inserting the contraceptive implant, so normally it is inserted during a period, usually between day 1 to day 5 of your period (day 1 being the day your period starts). However, it can be inserted at any time of the cycle if the doctor is satisfied that there is no chance that you are pregnant.  Usually, your doctor will advise you to avoid having sex or using condoms for seven days after it is inserted, just to ensure it has started to work. How effective is it? It is thought that the failure rate of the Implant is about 0.03%, this means you have about a 1 in 3000 chance of getting pregnant if you use the Implant as your contraceptive of choice. Compare this to the Pill, where some studies have reported a failure rate as high as 8%.  However, this is because using the Pill as a contraceptive requires you to remember to take it every day, and some women find it really hard to remember to take it every single day. How does it work? The Implant releases a low dose every day of a hormone called progesterone. This prevents pregnancy by stopping you from ovulating, or producing an egg each month.  It also thickens your cervical mucus (lovely!) to stop sperm from getting in. How long does it last? The Implant  lasts for three years, which means, when you have it fitted, you should not need to think about contraception for three years. Is it expensive? If you have a medical card, for most people getting the implant fitted is free.  If you do not have a medical card, you will need to buy the device in the chemist. For most people, that will bring you up to your drug payment scheme cut-off. Also, the doctor will charge a fee to insert the implant.  However, once it is in and all is going well, you should not need any further check-ups for up to three years, so really, it saves you money in the long-term.  In fact, the Pill is more expensive as it requires you to buy the tablets each month and also attend the GP for periodic health checks. We will focus more on the Implant next week.