Knowledge Centre · Patient guide
The implant, explained
A small rod in your arm that prevents pregnancy for years. How long it lasts, how it goes in and comes out, what happens to your bleeding, and which medicines can affect it.
The implant is one of the most effective methods of contraception. Once it is in, there is nothing to remember. This guide from Network One Health explains how it works and what to expect.
What the implant is
The implant is a small, flexible rod, or two rods, placed just under the skin of your arm. It slowly releases a progestogen hormone. It contains no oestrogen.
It is a long-acting reversible contraceptive. That means it lasts for years, but you can have it taken out whenever you choose.
How well it works
Out of 100 women using the implant for a year, fewer than 1 gets pregnant, with typical or perfect use (South African guideline and WHO 2025 estimates agree). This is true in real life, not only in perfect conditions, because there is nothing to forget.
The implant does not protect against STIs or HIV. Use condoms as well if you may be at risk.
How long it lasts
How long your implant lasts depends on the type.
- Single-rod implants last 3 years.
- Two-rod implants last 4 or 5 years, depending on the type.
Your clinician will tell you which type you have and write down the date it needs to come out. Keep that date somewhere safe.
Having the implant put in
Your clinician will ask about your health and your medicines, and check that you are not pregnant. A blood pressure check is good practice. You do not need a pelvic examination.
Your clinician numbs a small area of your arm with a local anaesthetic, then places the implant under the skin. It takes a few minutes. You go home with a small dressing on your arm.
When it starts working
- If it goes in within 7 days of the first day of your period, you are protected straight away.
- At any other time, use condoms or do not have sex for the next 7 days.
You do not need a routine follow-up visit. Come back at any time if you have questions or problems, and when it is time for removal.
Having the implant taken out
You can ask for removal at any time, for any reason. You do not need to wait until it expires.
Your fertility returns straight away after removal. If you do not want to get pregnant, start another method at the same time, or have a new implant put in.
To take it out, your clinician numbs the area with a local anaesthetic, makes a tiny cut and removes the implant. It takes a few minutes.
What happens to your bleeding
Changes to bleeding are common with the implant. Knowing what to expect before it goes in helps many women feel more at ease.
You may have:
- spotting or light bleeding, especially in the first year. This is common and not harmful.
- no periods at all. This is not harmful and does not need treatment.
- heavy or long bleeding. This is less common.
See a clinician if bleeding lasts more than 8 days, or is twice as heavy as your usual period. Also see a clinician if you start bleeding after a long time with no periods.
If the bleeding bothers you, a clinician can check for other causes and may offer treatment. If it still does not suit you, the implant can be removed.
The implant does not affect your bone density.
Medicines that can affect the implant
Some medicines lower the hormone level from the implant. This can make it work less well.
- Efavirenz, an HIV medicine. Women taking efavirenz have become pregnant with an implant in place.
- Rifampicin and rifabutin, used to treat TB.
- Some epilepsy medicines, such as phenytoin and carbamazepine.
Even with these medicines, the implant still works better than most other methods used in real life. But the copper IUD and the DMPA injection are not affected at all. For women taking these medicines long term, they are usually the first choice.
If you still prefer the implant after talking it through, that is your choice to make. Your clinician will suggest using condoms as well.
Dolutegravir, a common HIV medicine in South Africa, is unlikely to affect the implant.
Always tell your clinician about every medicine you take, including when you start something new.
When to see a clinician
- You think you might be pregnant. Pregnancy with an implant is rare. If it happens, it needs to be checked early.
- Severe pain low in your tummy
- Bleeding that is very heavy or goes on for more than 8 days
- You start a new medicine for HIV, TB or epilepsy
- You cannot feel the implant in your arm
- Signs of infection where the implant went in, such as redness, swelling, pus or fever
Where to get the implant
Contraception is available at public clinics in South Africa. Ask your clinic whether it offers the implant.
What to expect at Network One Health
At Network One Health, we talk about bleeding changes before the implant goes in, so you can decide with the full picture. If it stops suiting you, removal is a simple request, not a debate.
Booking and questions: WhatsApp Noma on 065 072 5315.
Emergencies: If you think you have a medical emergency, go to the emergency unit at your nearest hospital or call 10177.
Sources and guidance
- Selected practice recommendations for contraceptive use, fourth edition (2025), World Health Organization (WHO)
- National Contraception Clinical Guidelines (2021), National Department of Health, South Africa
Your next step
If you are thinking about an implant, or yours is due to come out, book with us:
Prices are what you pay, not an estimate. We confirm your own fee after a short eligibility and affordability check, and there is no obligation.
Rather just talk it through?
Tell us what you have read and what you are worried about. We call you back. You do not need a referral, and nothing is booked until you say so.
We call back Monday to Friday, 9am to 5pm, usually the same working day.