Implantable contraceptives: IUD coil and sticks

Which ones are they?

Implantable contraceptive methods represent a new medical milestone achieved thanks to the improvement of contraceptive techniques.
Among the implantable contraceptive methods, we remember:

Spiral Hormonal IUD
Spiral copper IUD (also among the emergency contraceptive methods)
Implantable sticks

While both IUD spirals are contraceptives that can be implanted in the woman's uterus, the sticks are implanted under the skin, precisely on the inner upper arm (6-8 cm from the elbow).

Key points

The table describes the general characteristics, advantages and disadvantages of each implantable contraceptive method. Furthermore, a percentage value is reported which expresses the theoretical protection guaranteed by the contraceptive from unwanted pregnancies.

SPIRAL Hormonal IUD (Mirena)

General characteristics Benefits Disadvantages Protection from unwanted pregnancy

It is a small device of various shapes (generally similar to a T), which is implanted in the woman's uterus by a gynecologist
Typically, the IUD coil is inserted into the uterus during menstruation, and left there for a few years.
The hormones (progestins) are contained in a sort of semipermeable membrane, and gradually released inside the uterine cavity to prevent fertilization of the egg.

The contraceptive action of the implantable contraceptive is guaranteed for 3/5 years, after which the spiral is removed and eventually replaced with a new one.
It significantly reduces menstrual flow, avoiding heavy menstruation, menorrhagia, dysmenorrhea
Gradual release of the progestogen reduces the risk of endometrial / uterine polyps
Reduces the risk of local hyperplasia

It does not protect against sexually transmitted diseases
During the menstrual cycle, the spiral may shift
Breast swelling, acne, migraine
Recommended for women who have given birth to at least one child (to be sure of their fertility)
bacteria could nestle more easily in the vicinity of the spiral and generate rather unpleasant disturbances
Vaginal dryness and hot flashes
Not recommended in case of vulvodynia and other inflammations
Need to undergo annual gynecological checks

High: 98-99.9%
The contraceptive efficacy of the hormonal spiral could be compromised by the concomitant use of certain drugs (eg anticonvulsants, antibiotics)

Copper IUD spiral

General characteristics Benefits Disadvantages Protection from unwanted pregnancy

Small plastic T-shaped device surrounded by a thin coiled copper wire.
The contraceptive method is implanted in the woman's uterus by a gynecologist during menstruation and released there for 3-5 years.
The copper spiral protects against unwanted pregnancies by exerting an excellent spermicidal action, preventing the fertilization of the egg and hindering the motility and survival of the spermatozoa.

The application of the IUD within the next 5 days from a potentially risky intercourse (emergency contraception) guarantees 99% of the contraceptive effect
It interferes with the motility of spermatozoa
Reversibility of the contraceptive method: after the removal of the IUD spiral from the uterus, the total restoration of fertility is guaranteed
The implantable contraceptive can be removed at any time
Reduced risk of ectopic pregnancy (after IUD removal)

It does not protect against sexually transmitted diseases
During the menstrual cycle, the spiral may shift
The menstrual flow of users of this implantable method remains unchanged (it does not decrease, unlike hormonal IUDs). Sometimes your menstrual cycle may be heavier than normal.
The copper spiral can create spotting in the first few months of use
It must not be implanted in the uterus in case of salpingitis, metritis, cervicitis, PID and endometritis
Possible increase in menstrual pain
Need to undergo one or two gynecological checks every year
It is not suitable for women who have just given birth: in this case, the contraceptive method is more likely to be expelled
Not suitable for nulliparous women
It can create allergic reactions to copper. Contraindicated for women who are also allergic to nickel
Do not take in case of severe anemia

High: 98-99.9%
The insertion of the IUD within 5 days of a risky intercourse is able to avoid the onset of 99% of pregnancies

Implantable sticks (subcutis)

General characteristics benefits Disadvantages Protection from unwanted pregnancy

It is a still little known method of contraception in Italy. It consists in the implantation of a stick (Implanon), 4 cm long and 0.2 cm wide, capable of releasing progestin hormones (etonogestrel). The device is inserted under the skin, in the inner upper part of the non-dominant arm, at the height of 6-8 cm from the elbow.
The stick should be implanted in the period between the first and fifth day of the woman's natural menstrual cycle
The progestin, by modifying the thickness of the cervical mucus, denies the spermatozoa the possibility of reaching and fertilizing the egg. By doing this, it is possible to prevent pregnancy.
This implantable contraceptive method exerts its therapeutic action mainly by inhibiting ovulation.

The implantation of a contraceptive stick under the skin is indicated to prevent pregnancy
Method reversibility: fertility is guaranteed as soon as the stick is removed from the skin
It does not require a regular intake (limitation of the contraceptive pill)
The implantable contraceptive method guarantees excellent coverage from unwanted pregnancies for 3-5 years
Suitable for women aged between 18 and 40 years
Lesser menstrual pain than in women who do not use any contraceptive method
The implantable contraceptive stick can be removed at any time. Removal of the device must be done by an experienced gynecologist.

It does not provide any protection from sexually transmitted diseases
Possible hematoma formation immediately after implantation of the contraceptive rod in the arm
Implantation of a hormonal rod can cause abnormal uterine bleeding (thus spotting / hypermenorrhea) or amenorrhea.
It can cause chloasma, acne, mood swings, dizziness and decreased libido
Possible weight gain (estimated around 2Kg in 5 years)
It is not indicated for diabetic women because a contraceptive formulated exclusively with progestins can affect peripheral insulin resistance and glucose tolerance.
Not indicated in case of venous thromboembolytic disorders, liver disease or hypersensitivity to one or more components of the rod
Possible increased risk of ectopic pregnancy
If the implant is not performed correctly, the contraceptive stick can be expelled

Excellent protection from unwanted pregnancy (over 99.9%)
The risk of failure of the implantable contraceptive method may be higher in obese or obviously overweight women