Assessing the Contraceptive Implant: Is It Right for Women with Health Conditions?

Last updated on January 1st, 2025 at 08:16 pm

The contraceptive implant is a widely used method of long-term birth control, offering significant advantages for many women. This tiny device, about the size of a matchstick, is inserted under the skin of the arm and can help prevent pregnancy for up to three years. With its convenience and high efficacy rate, it is an ideal choice for women seeking long-term birth control.

However, as with any medical treatment or procedure, there are important factors to consider before deciding on this method – particularly if you have health conditions. Understanding whether contraceptive implants align with your health profile is crucial in making an informed decision.

Understanding the Contraceptive Implant: An Overview

The contraceptive implant is a small, flexible rod that is inserted under the upper arm’s skin, releasing hormones that thicken cervical mucus to inhibit sperm movement and prevent ovulation. This method of birth control is over 99% effective and can potentially last up to three years. Its convenience and reliability make it popular among women seeking long-term contraception. 

The implant is particularly appealing as it requires minimal maintenance once inserted, allowing users to focus on their daily lives without the need for daily pills or frequent visits to a healthcare provider.

Who Is an Ideal Candidate?

An ideal candidate for the contraceptive implant typically includes women who:

• Do not intend to conceive for the next few years
• Prefer long-acting reversible contraception
• Looking for a progesterone-only method of birth control
• Preferred planned parenthood
• Desire for a convenient and effective way to prevent pregnancy

However, it is essential to note that certain underlying medical conditions may affect the suitability of contraceptive implants for some women.

Health Conditions That May Affect the Suitability of Contraceptive Implants 

Certain health conditions can interact negatively with the use of contraceptive implants. Women with the following conditions should consult healthcare professionals thoroughly before considering this birth control method:

Blood Clots

A history of blood clots significantly raises concerns regarding the use of contraceptive implants. Women with clotting disorders may be at an increased risk of developing further complications when using hormonal contraception, necessitating careful evaluation by healthcare providers.

Cardiovascular Issues

The hormones released by the contraceptive implant, primarily progestin, can lead to increased blood pressure. For individuals with pre-existing hypertension or other cardiovascular issues, this elevation poses additional risks, potentially exacerbating their condition and leading to serious complications such as heart attacks or strokes.

Diabetes

Women with diabetes using hormonal contraceptives may experience higher blood glucose levels and increased insulin requirements. This is particularly concerning for those with poorly managed diabetes, as elevated blood sugar can exacerbate existing complications associated with the condition, such as diabetic neuropathy, nephropathy, and retinopathy. 

The hormonal changes induced by the implant could potentially lead to further destabilisation of glycemic control, increasing the risk of adverse health outcomes.

Breast Cancer History

For women with a history of hormone-sensitive breast cancer, particularly those with estrogen receptor-positive (ER+) tumours, introducing additional hormones may pose a risk. These cancers rely on estrogen and progesterone for growth and proliferation, meaning that any external source of these hormones could potentially stimulate tumour activity, leading to the recurrence or progression of the disease. 

Uncontrolled High Blood Pressure

Although progestin-only contraceptives, like implants, do not significantly elevate blood pressure in most users, individuals with uncontrolled hypertension (typically defined as readings of 160/100 mmHg or higher) should be cautious. It is recommended to avoid hormonal contraceptives when having uncontrolled high blood pressure due to the potential for increased cardiovascular risks, including stroke and myocardial infarction.

Kidney Disease

In individuals with impaired kidney function, hormones may be affected, potentially leading to altered levels in the bloodstream. This can result in unpredictable effects of the implant, including reduced effectiveness in preventing pregnancy or increased side effects due to higher hormone levels remaining in the system longer than intended.

Liver Disease

Women with liver conditions should be cautious when considering hormonal contraceptive implants due to the potential negative effects on liver function. The liver is responsible for metabolising hormones, and impaired liver function can lead to elevated hormone levels, increasing the potential risk of side effects and reducing the effectiveness of the implant.

Undiagnosed Vaginal Bleeding

Unexplained vaginal bleeding requires thorough evaluation and monitoring before considering a contraceptive implant because it may indicate underlying health issues needed to be addressed. Abnormal bleeding can stem from various causes, including hormonal imbalances, uterine fibroids, polyps, infections, or even more serious conditions like endometrial cancer. 

Before starting a hormonal contraceptive like an implant, it is essential to rule out these serious conditions to ensure that the contraceptive method does not exacerbate any existing health issues.

Consulting Healthcare Providers

Given these potential implications, it is essential for women with kidney disease to consult healthcare providers before considering a contraceptive implant. A thorough evaluation of their health status, kidney function, and any other underlying conditions is crucial. Healthcare professionals can help determine whether hormonal contraception is appropriate or if alternative methods would be safer and more effective.

Bottom Line

While contraceptive implants can be an effective form of birth control for many women, those with health conditions should approach this option with caution. The potential for altered hormonal metabolism, increased risk of complications, and the need for careful medical oversight highlight the importance of individualised care in this population.