Irregular bleeding with the implant. Same implant different side effects?


Implants are very effective contraception

  • they have very few health risks
  • they last for 3 years
  • they are completely reversible.

However one of the main problems experienced by women using the implant is irregular bleeding.

1/3 of women who have their implant removed early do so because of bleeding problems.


We do not know the exact cause of irregular bleeding on the implant. It may be caused by increased fragility of the surface blood vessels on the lining of the womb or by changes in natural hormones which are still present while on the implant.

It seems to me that the most annoying thing for women considering the implant is that we cannot predict who will get irregular bleeding and who will not.

A discussion was started on this forum yesterday:
Is it possible to have no bleeding with one implant and irregular bleeding with another?

I can see how frustrating this must be, but the truth is, our bodies can react to the same contraceptive or hormone in different ways over time.
The best thing to do when using any contraception, is ensure you have access to good information, advice and contraceptive services.

It is also good practice to exclude other possible causes of bleeding - just in case. So if you have unexpected bleeding then you should do a test for sexually transmitted infection, a pregnancy test and make sure that you are up to date with your smear tests.

I believe that if women know they can have the implant removed if it is causing problems, then they are more likely to give it a try.
Also, if they know irregular bleeding is fairly common, then they may be less worried when it occurs.
Thirdly, if they know there are some treatments available for irregular bleeding, then that may also be reassuring.

So what I am trying to get at is, keep asking questions, and be patient when trying to find the right method for you, and know that this may well change over time too.


I had bleeding with the implant, which was pretty much regular spotting for almost a year. All my doctor could say was wait to see if it stopped at some point but I wasn’t exactly reassured that this was normal. I eventually got it removed early for this reason and tried the combined pill instead which worked just fine. I’m glad I knew I had the option to have it remove though and I am now happy on the pill.


That’s really interesting to hear. Many health professionals think that bleeding on the implant will settle down over time. However, the evidence is that if you have unacceptable bleeding in the first 3 months this may well continue. So its worth asking health professionals who are trying to encourage you to continue to just check the guidance from the Faculty of Sexual and Reproductive Health Care - in case it is helpful I have copied the relevant paragraph here:

Fewer than one-quarter of women using the progestogen-only implant will have regular bleeds.
Infrequent bleeding is the most common pattern (approximately one-third); around one-fifth
of women experience no bleeding; and approximately one-quarter have prolonged or
frequent bleeding. Altered bleeding patterns are likely to remain irregular.

Hope this is helpful.


Once you have removed the implant - how long do you have to wait before you can get pregnant?


Hi @flo. You can start trying for a pregnancy immediately after using the implant. Your fertility should return to normal for you within 7 days.