This is a question a reader sent to me recently.

Q: Dr Ketch, I am on the contraceptive implant. I had it inserted on March 16 last year and had no problems then. But this year I started spotting and it has been almost a whole month. I also have tummy cramps, leg cramps and I am always in a bad mood. Is this normal?

A: Yes, this can happen.

For those who may not know, the contraceptive implant is a small device inserted under the skin of the upper arm. It protects against pregnancy for about 3 years.

It works by releasing a hormone called progestin, which:
• prevents the ovary from releasing an egg
• thickens cervical mucus so sperm cannot reach the egg

Because of these hormonal changes, menstrual patterns can change.

Some women may experience:
• longer or irregular periods
• lighter periods
• or even no periods at all after some time

Other possible side effects include mood changes, headaches, nausea, acne, and cramps.

These symptoms usually settle within 3 to 6 months after insertion.

The implant is also a good option for breastfeeding mothers because it does not contain estrogen and therefore does not interfere with breast milk production.

However, please see your doctor if:
• bleeding becomes very heavy
• symptoms persist beyond a few months
• you develop severe headaches
• you notice a breast lump or yellowing of the eyes

Also note that this method is not suitable for women with breast cancer.

I hope this helps.

– Dr Ketch