Sitting in the surgery doctors waiting room to say I was nervous was an understatement. I was anxiously tapping my foot on the floor as I answered questions about my sexual health. Have I ever been paid for sex? Have I ever been forced into sex? Have I ever had abusive sex? Some of the detailed questions were strange, but I suppose they have to ask them as nurses in order to safeguard, both as an arse-covering exercise and to flag up any would-be problems or concerns. And so here I was for my fourth implant exchange.
Looking on the NHS website, Nexplanon, otherwise known as the contraceptive implant is a small flexible plastic rod that looks a little like a match stick. It is placed under the skin in your upper arm by a doctor or nurse and releases the hormone progestogen into your bloodstream to prevent pregnancy. Lasting for 3 years, it is more than 99% effective and can be useful for women who can't use contraception that contains oestrogen.
The science-y part states that the implant steadily releases the hormone progestogen into your bloodstream, which prevents the release of an egg each month AKA your period. It also thickens the cervical mucus, which makes it more difficult for sperm to move through the cervix, and thins the lining of the womb so a fertilised egg is less likely to implant itself and cause that dreaded pregnancy!
The NHS website also states that you can have the implant put in at any time during your menstrual cycle, as long as you're not pregnant. If the implant is fitted during the first 5 days of your menstrual cycle, you will be immediately protected against becoming pregnant, however, if it's fitted on any other day of your menstrual cycle, you'll need to use additional contraception (such as condoms) for 7 days, although if you ask the sexual health nurse or doctor they will usually provide you with as many as you need in a nice little discreet packet, almost like a goody bag or sticker like from the Dentist.
Some of the reasons to choose the implant over other forms of contraception are that once the implant is in place, you don't have to think about it again for 3 years and is very useful for women who find it difficult to remember to take a pill at the same time every day like me. Obviously, the implant can be taken out if you have side effects which could include periods may become irregular, lighter, heavier or longer but once removed your natural fertility will return very quickly. As soon as that implant has been removed, you'll no longer be protected against pregnancy. You can also use this method until you reach the menopause when a woman's monthly periods stop naturally.
Another common side effect is what I have most of the time which is called amenorrhoea when your periods stop altogether. It's not harmful, but you may want to consider this before deciding to have an implant if unlike me you prefer Aunt Urma staying more regularly. I think this, along with the fact I am incredibly forgetful and blase about the small stuff in life, means this is perfect and I only really need to think about it when I am having it exchanged and replaced.
I mean obviously, it goes without saying that some medicines can make the implant less effective and that it won't work or protect against sexually transmitted infections (STIs), so you may need to use condoms as well if you are not familiar with your bed-fellow. I think I found it especially useful when I was dating (although this feels like many, many moons ago now) as I was not only using condoms but also relying on my implant too as a sort of double barrier, just in case the condom split or came off.
To have it removed as I have this evening is simple as well and mostly pain-free. Starting with a local anaesthetic to numb the area on the inside of your upper arm, the implant is then inserted under your skin (mine was after the doctor made a tiny cut in my skin and gently pulled the implant out). It only takes a few minutes to put in and feels like having an injection so you won’t be in need of any stitches afterwards.
As I type to you all tonight I have been through this very quick and simple procedure several times over and, like me, when it's first put in you may feel some bruising, tenderness or swelling around the implant. My arm is killing me right now, mainly because the nurse took it out and nearly forgot to put me a new one back in, by which point the general anaesthetic had nearly worn off so inserting that little stick felt like pumping molten chilli sauce into my arm. But I am now protected, at least in part from Mr Warehouse's super sperm. His whole family seem to be able to procreate at a somewhat incredible level I don't think I have ever encountered before.
Don't get me wrong, as the day approached and even this afternoon as I thought more and more about it I know that this will be the last time I will have it going in as I will not be finishing the full term until September 2022. If Mr Warehouse had it his way we would have had children back when we met, aged twenty-two and me at twenty-three. I, however, prefer the more planned and thought out route, choosing to get life to a more stable place, with a house and well-formed relationship to steady the unpredictability of a child. And to think that the next time I lay down on that bed, fist punching the air will be when I have made the decision to breed and make more little me's!
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