Heungdeok Dream Women's Clinic Doctor's Column
Obstetrics & Gynecology Column

Implanon Insertion Pain: When Can You Get Pregnant After Removal?

A guide to the steps of Implanon insertion, the pain that can follow, and when pregnancy becomes possible after removal.

Published 2026-10-14 Updated 2026-10-14 Reviewed by Soojin Han, Medical Director · Obstetrics & Gynecology Specialist

Implanon is a contraceptive implant placed under the skin of the inner arm that stays effective for up to 3 years. It offers a contraceptive rate of over 99% even for people who find it hard to remember a daily pill. The procedure takes about 5 minutes after local anaesthesia, and the key point is that after removal the ovulation cycle returns within two days, so pregnancy is possible within the first menstrual cycle.

Without knowing in advance what happens on the day of insertion, what the pain is like and how the body recovers after removal, the process can feel vague. Even if there are no plans for pregnancy right now, knowing when removal may be needed and what the chance of pregnancy is afterwards can reduce anxiety.

This article goes through how Implanon works inside the arm, the order of steps on the day of the procedure, the pain that can appear afterwards, and when pregnancy becomes possible after removal.

01

How does Implanon work inside the arm?

Key point
Implanon is a thin rod-shaped device 4 cm long and 2 mm thick that is placed under the skin of the inner arm and releases a steady amount of hormone into the bloodstream each day. It suppresses ovulation and thickens cervical mucus to block sperm, and once inserted it remains effective for about 3 years.

Implanon is implanted in the arm and releases a progestogen hormone. By suppressing ovulation, thinning the uterine lining and thickening cervical mucus, it maintains a contraceptive rate of over 99%.

Unlike the oral contraceptive pill, a single insertion stays effective for 3 years, so it is an alternative for people who tend to forget pills or who find an intrauterine device a burden.

  • Suppressing ovulation — the progestogen absorbed each day stops the ovaries from ovulating, which prevents pregnancy
  • Changes to the uterine lining — the lining becomes thinner, creating an environment where implantation is difficult
  • Changes to cervical mucus — the mucus becomes thicker, making it harder for sperm to enter the uterus
Anatomy illustration related to Implanon Insertion Pain: When Can You Get Pregnant After Removal?
02

What happens on the day of the procedure?

Key point
A consultation beforehand checks for pregnancy and general health, and the timing of insertion is then decided. From local anaesthesia to insertion takes about 5 minutes. Insertion within 5 days of the start of a period is recommended, and afterwards the position can be confirmed by touch.

Before Implanon is inserted, pregnancy, blood clots, liver disease and similar conditions are checked. Insertion is recommended within 5 days of the start of a period, when the uterine lining is thin.

The device is inserted after local anaesthesia, and the procedure is finished within 5 minutes from the anaesthetic. Straight afterwards the inner arm is felt to confirm the position, and if the device cannot be felt, imaging is used to check.

  • Consultation beforehand — pregnancy is checked together with conditions that limit use, such as blood clots or liver disease
  • Deciding the timing — within 5 days of the start of a period is the recommended standard
  • Insertion after local anaesthesia — from the anaesthetic to completed insertion takes about 5 minutes
  • Checking the position — if the device cannot be felt by hand, it is checked again with imaging
03

What kind of pain can appear after the procedure?

Key point
Once the anaesthetic wears off, the insertion site may feel stiff or throb, but this is a natural reaction that in most cases settles within 2 to 3 days. Irregular bleeding or absent periods may appear in the first few months, as the uterine lining adapts to the new hormonal environment.

When the anaesthetic wears off, the insertion site may feel stiff, but this is a reaction of the tissue under the skin and settles within 2 to 3 days. Avoiding pressing hard on the area reduces the pain.

In the first few months, irregular bleeding or absent periods are commonly experienced. If this continues for a long time or feels different from usual, speak with a medical professional.

04

When is pregnancy possible after removal?

Key point
Implanon does not store hormone in the body; it releases small amounts into the bloodstream, so the contraceptive effect ends as soon as it is removed. Within two days hormone levels fall below the contraceptive level and the ovulation cycle restarts, making pregnancy possible within the first menstrual cycle.

Because it does not store hormone but releases it into the bloodstream each day, the contraceptive effect ends immediately on removal, and there is no need to worry about hormone remaining in the body.

Two days after removal, the hormone level falls and ovulation resumes. Pregnancy is possible from the first period onwards.

Soojin Han, Medical Director
Doctor's view

How the doctor decides

Soojin Han, Medical Director · Obstetrics & Gynecology Specialist

I check the body's condition before setting the timing

I do not go ahead with the procedure simply because of the date a patient would like. I first check for pregnancy and for conditions that limit use, such as blood clots or liver disease, and I also look at whether it is within 5 days of the start of a period, when the uterine lining is thin. Only then do I decide when to insert. Skipping this order can mean irregular bleeding lasts longer after the procedure, so I put this check first.

If the device cannot be felt, I move straight to imaging

I do not tell a patient to simply wait and see because the device cannot be felt by hand after the procedure. If the position cannot be confirmed, I move on to imaging and first check whether the device has settled properly. That way I can tell whether the device has moved out of position or is simply in a place that is hard to find by touch.

I do not recommend removal on the basis of early irregular bleeding alone

I do not decide that removal is needed just because of irregular bleeding or absent periods in the first few months. I first work out whether this is a common change while the uterine lining adapts to the new hormonal environment, or whether another cause is also involved. That is how I can judge whether the adjustment period can be passed without an unnecessary removal.

I ask about pregnancy plans after removal as well

When a patient wants the implant removed, I do not just explain the timing of removal; I also ask about their plans for pregnancy afterwards. Because the ovulation cycle returns within two days of removal and pregnancy is possible within the first menstrual cycle, I believe telling patients who have plans about this timing in advance is an important part of care.

Summary

In summary

Implanon is a contraceptive device inserted in the inner arm that stays effective for about 3 years. The key points are that the procedure itself takes 5 minutes after local anaesthesia, and that after removal the ovulation cycle returns within two days and pregnancy becomes possible. Stiffness for a few days after the procedure and irregular bleeding in the first few months are in most cases a natural process of adjustment, but if pain or bleeding continues for longer than usual or differs from usual, or if the insertion site cannot be felt by hand, it is wise to have it checked without delay. Even without immediate plans, knowing when removal may be needed and what the chance of pregnancy is afterwards can help avoid confusion when the moment comes.

FAQ

Frequently asked questions

QDoes Implanon work as contraception from the very next day?
A

If it is inserted within 5 days of the start of a period, it works as contraception immediately. Outside that window, it is safer to use another method of contraception as well for a certain period.

QWhat should I do if the insertion site hurts?
A

Stiffness and throbbing usually settle within 2 to 3 days. If they continue beyond that time or get worse, have it checked by a doctor.

QDoes hormone stay in the body after removal?
A

Because the hormone is not stored, the effect ends immediately on removal. Within two days the level falls and ovulation begins.

QCan Implanon be used by someone with blood clots or liver disease?
A

Blood clots or liver disease can limit its use, so it is important to mention any relevant medical history during the consultation before insertion.

Soojin Han, Medical Director
Medical review
Soojin Han, Medical Director · Obstetrics & Gynecology Specialist
This content is general medical information and may not apply to every individual. Diagnosis and treatment are decided through a consultation.