Uzm. Dr. Ertan Özen
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- 36+years exp.
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Gynaecological Procedures
Subdermal contraceptive implant
What a subdermal contraceptive implant is, how the progestogen rod in the upper arm prevents pregnancy, how effective it is compared with the pill, injection and coil, what changes to bleeding to expect, approximate costs in Turkey against the UK, US and Germany, how insertion and removal work, risks, and what to ask a clinic before travelling.
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Prof. Dr. Zehra Neşe Kavak
GynaecologyVerified
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Subdermal contraceptive implant in Turkey: what it is and how it works
A subdermal contraceptive implant is a small, flexible plastic rod, about 4 cm long and roughly the width of a matchstick, that is placed just under the skin of the inner upper arm. It slowly releases a progestogen hormone (etonogestrel in the most widely used product) into the blood. The hormone does three things: it stops the ovary releasing an egg in most cycles, it thickens cervical mucus so that sperm have difficulty passing, and it thins the lining of the womb. Once placed, the implant works without any daily action from you and is classed as long-acting reversible contraception.
The implant contains no oestrogen, so it can be used by many women who cannot take the combined pill. It does not protect against sexually transmitted infections. This guide explains how it works, how effective it is, what to expect from insertion, removal and bleeding changes, what it costs compared with the UK, US and Germany, and what to check before arranging it abroad. For the wider specialty see gynaecology treatments in Turkey.
How effective is the contraceptive implant, and does it really work?
It is one of the most effective reversible methods available. With perfect and typical use the failure rate is below one pregnancy per 100 women per year, which is lower than the pill, the patch, the ring or the injection, because nothing relies on remembering. The NHS describes it as more than 99% effective. Fertility returns quickly after removal; most women can conceive within weeks to a few months.
What the evidence supports less strongly is how the implant behaves in the long term in every body. Effectiveness may be lower in women who take certain enzyme-inducing medicines, such as some epilepsy drugs, rifampicin or St John's wort, so tell the doctor about everything you take. The licence in many countries is for three years, and some guidance allows use up to five years; the doctor should tell you which limit applies to your product and when to plan replacement.
Subdermal contraceptive implant cost in Turkey compared with the UK, US and Germany
The figures below are approximate ranges for the implant, the insertion and a consultation, not hospital quotes. In the UK the implant is free on the NHS at sexual health clinics and GP practices, so the private figure only applies if you choose a private clinic. Availability of specific products in Turkey changes, so the first question is which implant the clinic can supply.
| Country | Approximate cost range |
|---|---|
| Turkey | €200 – €600 |
| United Kingdom (private) | €250 – €450 |
| United States | €0 – €1,300 (insurance dependent) |
| Germany | €350 – €600 |
What changes the price: the product and its licensed duration, the consultation and any tests, whether a pregnancy test and ultrasound are included, and the type of clinic. A package normally includes the consultation, the implant, insertion under local anaesthetic and a follow-up check. For many women in countries where it is free, the implant alone is not a reason to travel; it makes sense mainly when it is part of a longer stay or when public access is slow.
Implant, coil, pill or injection: which method suits you?
The nearest alternatives are other long-acting methods and daily or periodic hormonal methods. The right choice depends on your health, your bleeding pattern and how long you want protection.
| Method | Best suited to | Typical limits |
|---|---|---|
| Arm implant | Three to five years of protection without oestrogen | Unpredictable bleeding; needs a minor procedure to insert and remove |
| Hormonal or copper coil (IUD/IUS) | Long-term cover, lighter periods with the hormonal type | Insertion can be uncomfortable; small risk of expulsion |
| Combined or progestogen-only pill | Women who prefer to start or stop easily | Must be taken daily; lower typical effectiveness |
| Injection | Cover for about 12 weeks at a time | Return of fertility can be delayed; repeat visits |
A doctor should ask about migraine, blood clots, liver disease, breast cancer history and unexplained vaginal bleeding before recommending any hormonal method. If you have heavy periods because of fibroids, a different treatment may be needed; see fibroid removal or hysteroscopic myomectomy for what can be done when bleeding has a structural cause.
Who can have a contraceptive implant, and who should avoid it?
Many women can use it, including those who are breastfeeding after the first weeks and those who cannot take oestrogen. It is not suitable if you are pregnant or might be, have unexplained vaginal bleeding, have or have had certain breast cancers, have severe liver disease or have had a reaction to the product. Women with a history of blood clots, migraines with aura or high blood pressure should discuss progestogen-only options with a doctor, since the advice is usually reassuring but individual. A pregnancy test is advised before insertion unless you are within the right days of your cycle or already using reliable contraception.
How is the implant inserted, step by step?
- Consultation: health history, blood pressure and pregnancy check; the doctor explains bleeding changes and removal.
- Positioning: you lie with your arm bent and rotated outward; the doctor marks the site on the inner upper arm, above the elbow crease.
- Anaesthesia: a small injection of local anaesthetic.
- Insertion: a pre-loaded applicator slides the rod just under the skin. There is no cut and no stitch, and it takes a minute or two.
- Check: the doctor confirms that the rod can be felt under the skin, then applies a small dressing and a bandage.
The whole visit usually takes 15 to 30 minutes. If it is placed outside the first five days of your period, extra contraception such as condoms is advised for seven days, because it takes time to work. Follow the instruction for your product.
What do you feel afterwards, and how long is recovery?
Recovery is brief. Expect mild tenderness, a small bruise and slight swelling at the site for a few days. Keep the dressing dry for a day and the bandage on for a day or two, as advised. You can walk, work and travel the same day; heavy lifting or sports with the arm are usually fine after a short rest. If you notice spreading redness, pus, severe pain, numbness down the arm or a rod you can no longer feel, contact a doctor.
The only trip needed for insertion is one short appointment, so it fits into a day within a longer stay. Removal is a separate appointment, usually at home, and you should carry the product details so that a clinic at home can remove it.
Will it change my periods? Side effects to expect
Changes to bleeding are the main reason women stop using the implant early. In the first months the pattern can become irregular: some women stop bleeding altogether, some have infrequent or prolonged light bleeding, and some have frequent spotting. The pattern in the first three months tends to predict the pattern later, but it can change. Other reported effects include headache, acne, breast tenderness, mood changes and weight change; the evidence that the implant itself causes these in most women is mixed, and many women have none.
The doctor should offer a bleeding plan before insertion, and should say when it is worth coming back, for example for prolonged bleeding. Do not accept a quote that promises "no side effects".
Risks and complications of insertion and removal
Complications are uncommon. They include bruising, infection at the site, scarring and, rarely, an implant inserted too deeply or one that is difficult to find, which may need an ultrasound or a specialist for removal. Very rarely it can move from the insertion site. Official sources such as the NHS and the Faculty of Sexual and Reproductive Healthcare describe the implant as safe for most women, and recommend that insertion and removal are done by a trained clinician.
What happens when you want it removed, or want to get pregnant?
Removal is quick: a local anaesthetic is given, a tiny incision is made near the end of the rod, and the rod is slipped out with forceps. It takes a few minutes. You can use another method immediately after, or replace the implant at the same visit. Your fertility returns rapidly, so if you are planning a pregnancy talk to the doctor about timing; see pregnancy follow-up for what antenatal care involves.
How to choose a clinic, and red flags
Choose a licensed gynaecology clinic or hospital where a gynaecologist or trained doctor performs the insertion, checks your history and gives you the product details. Ask for the box and batch number to be recorded in a card you take with you, including the date of insertion and the date by which it should be replaced. Red flags include inserting without a pregnancy check, not confirming that the rod can be felt afterwards, no advice about bleeding changes, vague information about the product or unlicensed supply, and a price that is far below the pharmacy cost.
Questions to ask the clinic:
- Which implant do you use, and for how many years is it licensed?
- Will I be given a card with the insertion date, batch number and replacement date?
- Is the consultation, a pregnancy test and a follow-up check included?
- Who can remove it if I need that after I go home, and does my local service know the product?
- What should I do if I cannot feel the rod?
You can read how it works to see how a quote and a trip are arranged, or request a free quote.
Hospitals with Gynaecology in Turkey
Frequently asked questions
It is a thin plastic rod, about 4 cm long, placed under the skin of the inner upper arm. It releases a progestogen hormone that prevents ovulation and thickens cervical mucus, giving several years of contraception without daily action.
Yes. It is more than 99% effective, which is higher than the pill or injection in typical use because nothing needs remembering. Some medicines, including certain epilepsy drugs and St John's wort, can reduce its effect.
Roughly €200 to €600 for the implant, insertion and consultation, against about €250 to €450 privately in the UK, where it is free on the NHS. Product availability and what is included change the price.
Most products are licensed for three years, and some guidance allows use up to five. Ask the doctor which limit applies to your product, and write the replacement date on the card you are given.
A local anaesthetic is injected first, so you feel a sting and then pressure. Mild tenderness and bruising for a few days afterwards is common and usually settles without treatment.
The most common is a change in bleeding: irregular, prolonged or no periods. Headache, acne, breast tenderness and mood changes are also reported, though not by everyone, and bleeding often settles within a few months.
There is almost no downtime. You can walk, work and travel the same day, keeping a dressing on for a day or two. Contact a doctor if the site becomes red, swollen or very painful.
A doctor numbs the arm, makes a very small cut near the end of the rod and slips it out, usually in a few minutes. Fertility returns quickly afterwards, so use another method if you do not want to conceive.
Neither is universally better. The implant has no oestrogen and no uterine procedure but often changes bleeding. A hormonal coil can lighten periods but is inserted into the womb, which is more uncomfortable for some.
No stay is needed for recovery. Insertion takes one short appointment, so it can fit within a longer trip, but make sure you receive the product details so that removal can be arranged at home.
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