Hormone implant

The implant is a soft, flexible plastic rod that is pushed under the skin on the upper arm. It is 4 cm long and 2 mm thick. The progestin etonogestrel is perpetually released from the rod. This active ingredient is also found in some contraceptive pills.

The progestin from the rod reaches the blood. Its main effect is to prevent monthly ovulation and to thicken the mucus in the cervix.
The effect lasts for three years.

To insert the stick, the doctor pushes it directly under the skin, on the inside of the upper arm, with a special cannula after a local anaesthesia. Usually, this hurts only a little. The rod should be placed under the skin
and should be easy to feel under the skin. A pressure bandage is then applied for 24 - 48 hours to prevent from bruising.
The rod must be removed or replaced at the latest after three years. After local anaesthesia, the implant is palpated and pulled out through a small incision of 2 - 3 mm. This usually only takes a few minutes, but does not always have an immediate, smooth outcome. Sometimes the implant is difficult to remove or has to be removed with ultrasound or magnetic resonance imaging
(MRI). Sometimes a general anaesthesia and a larger skin incision are necessary for the removal.
There have also been cases where the rod could no longer be found in women.

Advantages

The hormone stick can be used by women who do not tolerate the hormone estrogen or are not allowed to take it because of considerable health risks. No intake-errors while taking the pill. The rod is one of the safest methods of contraception (see Reliability). In comparison to the Depot injection, there is a faster recovery of fertility after weaning.

Disadvantages

The hormone stick is one of the most expensive contraceptives. The menstrual period is often irregular. It is delayed or does not occur at all. There may be light or frequent intermenstrual bleeding, which is medically harmless. Some women complain of breast tenderness, headaches, mood changes or loss in sexual appetite.

Reliability

The contraceptive stick is one of the safest contraceptive methods (see Pearl-Index). The only prerequisite for reliability is that the doctors who use the stick should be sufficiently experienced. In some countries, including Germany, there were reports that there were unwanted pregnancies due to the fact that the hormone stick was not used correctly.
The Australian Society of General Practitioners advises all women to check the correct position a few days after the insertion by palpating the rod under the skin.
Some drugs such as broad-spectrum antibiotics, St. John's wort, some anti-epileptic drugs and psychotropic drugs reduce the contraceptive effect of the contraceptive rod. If you are taking medication, tell your doctor that you are using a hormone implant for contraception.

Accessibility

The hormone implant is a drug and must be prescribed, inserted and removed by a doctor after a thorough examination.

Costs

According to the scale of fees for doctors, the hormone stick should be covered by the health insurance company for women with statutory health insurance up to the age of 22. For various reasons, however, it is extremely rare for these costs to be covered. Therefore, you should check with your gynaecologist before opting for your insertions.

The hormone stick costs 300 to 350 € including the insertion. For the removal, up to 50 € will be charged.

Social welfare recipients and recipients of unemployment benefit II must bear all contraceptive costs themselves. In some municipalities and cities, however, there are exceptions. Hence it is worth clarifying on the spot whether it is possible to cover the costs after all.