Session 1 impanon next training module

1. Session I, Slide .11
Contraceptive Implants
Session (1): Characteristics of Implants

2. Session I, Slide .22
Objectives
At the end of this session, participants will be able to:
1. Describe the characteristics of implants in a manner that
clients can understand:
a. What implants are and how they work (mechanism and
onset of action)
b. Effectiveness
c. Side effects
d. Non-contraceptive health benefits
e. Possible health risks (complications)
f. Other characteristics (STI/HIV protection, ease of use,
return to fertility, when to initiate and discontinue)

3. Session I, Slide .33
Objectives (continued)
2. Demonstrate the ability to:
a. Screen clients for medical eligibility for implants
b. Explain to clients the insertion, removal, and follow-up procedures
c. Explain when to return to the clinic
d. Address common concerns, misconceptions, and myths
e. Conduct follow-up for implant clients in a way that enhances
continuing safety, satisfaction, and acceptance
3. Describe when to initiate use of Implants (postpartum, switching
from another method).
7. Demonstrate on anatomical models how to insert and remove
implants.
4. Explain how to manage side effects.
5. Identify conditions that require switching to another method.
6. Identify clients in need of referral for implant-related complications.

4. Session I, Slide .44
What Are Implants?
Progestin-filled rods (each about
the size of a match stick) that are
inserted under the skin
– Jadelle: 2-rod system, effective for
5 years
– Sino-implant (II): 2-rod system,
effective for 4 years (possibly 5)
– NEXAPLANON: 1-rod system,
effective for 3 years
– Norplant: 6-capsule system,
effective for 5 years (possibly 7);
no longer manufactured but some
women are still using it

5. Session I, Slide .55
Key Points for Providers and Clients
What it is:
– Small tubes placed under the skin of inner, upper arm.
– Hormones from the tubes blocks sperm from reaching egg and
prevents release of egg.
How to use:
– Specially trained provider inserts and removes implants.
– Nothing to remember to do after insertion.
What to expect:
– Changes in monthly bleeding including irregular bleeding, spotting,
heavier bleeding or no monthly bleeding, are common and safe.
Important to remember:
– Use another method if waiting for appointment.
– Use condoms if you need protection from STIs or HIV/AIDS.

6. Session I, Slide .66
Key Points for Clients
• Safe to use
• One of the most effective
methods
• Lasts for 3 years
• Can be removed any time if
you want to get pregnant

7. Session I, Slide .77
Effectiveness of Implants
In this progression of effectiveness, where would
you place implants?
Male Sterilization
Female Sterilization
IUDs
Progestin-Only Injectables
Combined Oral Contraceptives
Male Condoms
Standard Days Method
Female Condoms
Spermicides
Less
effective
More
effective
Less
effective
More
effective
Implants

8. Session I, Slide .88
Implants: Mechanism of Action
Thickens
cervical mucus
to block sperm
Implants work in two ways
Implants have no effect on an existing pregnancy.
Suppresses hormones
responsible for
ovulation

9. Session I, Slide .99
Implants: Characteristics
• Have side effects
• Require minor surgery
to insert and remove
• Cannot be initiated
and discontinued
without provider’s
help
• Provide no protection
from STIs/HIV
Source: Hatcher, 2007; WHO, 2010; CCP and WHO, 2011.
• Very safe and 99.95%
effective
• Easy to use
• Fertility returns without
delay when removed
• Can be used by
breastfeeding women
• Offer health benefits

10. Session I, Slide .1010
Implants: Health Benefits
• Reduced risk of symptomatic pelvic
inflammatory disease (PID)
• Reduced risk of iron-deficiency anemia
• Reduced risk of ectopic pregnancy
– 6 per 100,000 in implant users
– 650 per 100,000 in women using no contraception
Source: CCP and WHO, 2011; Task Force for Epidemiological Research
on Reproductive Health, 1998.

11. Session I, Slide 11
Some users report changes in bleeding
patterns:
Possible Side Effects of Implants (part 1)
First several months:
• Lighter bleeding and
fewer days of bleeding
• Irregular bleeding
• Infrequent bleeding
• No monthly bleeding
After about one year:
• Lighter bleeding and
fewer days of bleeding
• Irregular bleeding
• Infrequent bleeding
How would you
feel about these
side-effects?*Nexplanon users are more likely to have
no monthly bleeding than irregular
bleeding.

12. Session I, Slide .1212
Possible Side Effects of Implants
(part 2)
• Headaches
• Lower abdominal pain
• Acne (can improve or worsen)
• Weight change
• Breast tenderness
• Dizziness
• Mood changes
• Nausea, nervousness

13. Session I, Slide .1313
Group Activity
Implants Fact Sheet
Review the fact sheet.
What additional questions
or comments do you have
about the characteristics
of implants?