I'm no stranger to birth control. I've been on-and-off the pill for the better part of my six-year relationship with my boyfriend. It was something we deemed necessary to prevent any unwanted pregnancies, and as it turns out, it helps regulate my cycle as I have polycystic ovarian syndrome (PCOS)—something I found out fairly recently.
But taking oral contraceptives was a bit of a chore: I had to take it at the same time every day, and I wasn't very good at that. If I missed taking it for two days, I'd have to wait until my next cycle to take it again. Because of that, I was looking for something more long-term and less of a daily task. I first heard about birth control implants when a friend from the States mentioned hers in passing.
I hadn't heard about it before then, but it already seemed like the best option for me. The pills I had been taking weren't the cheapest (as those were the ones that worked best with my body) and were starting to get pricier as time went on. There are other long-term options, of course, but I wasn't comfortable with the idea of having an IUD inserted into my uterus. After comparing notes on the different available methods available here, I decided to proceed with the implant.
What exactly is The Implant?
The progestin-implant, coined the "family planning implant" by the Department of Health (DOH), is a plastic rod that is roughly matchstick-sized, and inserted under the skin of the inner arm. ICYDK, progestin is a synthetic version of progesterone, a naturally-occurring hormone in charge of the body’s menstrual cycle. The implant will continually release a steady dose of hormones over a few years, after which it should be removed (and replaced as needed); you may also have it removed before then. The implants being used in the Philippines are brands called Implanon and Implanon NXT, which have an effectivity length of three years.
The implant is a highly effective form of birth control; it's over 99 percent effective, making it one of the more reliable birth control methods. According to the World Health Organization, "the primary mechanisms of action of the implants include thickening cervical mucus (making it difficult for sperm to penetrate) and preventing ovulation in about half of menstrual cycles."
In November 2017, the Supreme Court lifted its Temporary Restraining Order (TRO) on the implants after they were certified to be non-abortifacients by the Food and Drug Administration.
How much does The Implant cost?
Not gonna lie: A big factor that was putting me off from getting it done was the cost. As a freelancer, I don't have medical insurance (yet), and I wasn't prepared to pay a big sum in one go (vs. the pill, which was something I paid monthly and split with my boyfriend) if I had to get a gynecologist to do it.
After researching where I could get it done in the Manila, I stumbled upon an article that introduced me to Likhaan Center, a non-government and non-profit women's health clinic established in 1995 that provides free and direct health care services to women. If you have PhilHealth, you may avail of their Subdermal Contraceptive Implant Package for P3,000.
If you choose to have this done by a private practitioner, I'm not sure about the total cost with insertion, but the actual implant costs around P5,000.
What it was like to get The Implant
At the center, a nurse asked about my medical history and gave me a run-down of the possible side-effects before proceeding. I picked which arm to use for insertion of the implant (usually this is the non-dominant one) and was asked to lay down. The area is disinfected and numbed. Once the anesthesia kicked in, the nurse proceeded with insertion, and that was pretty much it. The procedure took less than five minutes! I was asked to feel the rod under my skin to confirm that it was inserted properly.
As for the pain, it'll depend on your tolerance but it was generally a painless procedure that required no incisions. The anesthesia caused a sharp stinging pain and hurt more than the actual insertion. My arm was in a bandage for 24 hours, after which I changed the band-aid as needed. There was some light bruising around the area for a week or so, and for me, it felt a little tender for two weeks.
The nurse will give you care instructions to avoid infection, and ask you to come back for a check-up a month following the procedure to make sure everything is normal.
Precautions and possible side effects of The Implant
After the insertion, your health care practitioner will advise you to refrain from sexual intercourse for one week. If not, use a condom. Ideally, it's recommended to get the implant while you're on your period so there will be no need for other forms of contraception.
Changes in your menstrual cycle is normal. According to the nurse at Likhaan, most women who get the implant experience either reduced bleeding on their period or having it stop altogether. Other side effects may include minor bleeding or spotting in between periods, mood swings, acne, headaches, weight gain, menstrual cramps, and breast tenderness. Like other forms of contraception, these effects will differ between each person. The fertility effects of the implant are reversible, meaning they will only last as long as it is inside the body. Once it is removed, it is possible to become pregnant right away.
However, the implant will not work if you already are pregnant and will not prevent contraction and spreading of sexually-transmitted diseases (STDs). Using condoms are still the best way to prevent STDs.
Tips for visiting Likhaan Center
The main office, located in Quezon City, is open from Mondays to Saturdays. Procedures are only conducted on Mondays and are on a walk-in basis only. Make sure to go when they open to avoid a long wait! Don't be shy to bring an emotional support partner, be it your husband/boyfriend/friend, as I noticed most patients visiting that day had a companion!
If you can, consider making a small donation to the center; just mention the health care practitioner attending to you.
(Check their Facebook page for operating hours and for their other partner centers).
If you're looking into a more long-term method of birth control, for whatever reason, I highly suggest looking into the subdermal contraceptive implant. It's effective, reversible, relatively painless, and relatively affordable (and even provided for free by Likhaan) compared to other options. Best to check with your doctor before proceeding, and as always the choice is yours.