The number of women using hormone implants for contraception has risen five-fold in five years and the popularity of condoms is declining, NHS data shows.
The implants figure has soared from 16,600 in 2005 to almost 82,000 this year in England, with the devices especially popular with younger women and teenagers. Some 10% of girls and women aged 16-19 on some form of contraception say they prefer an implant; five years ago the figure was 1%.
Over the same period the proportion of women using the condom as their main form of contraception fell from 30% to 25%, the figures show.
Sexual health experts say the shift shows that women are increasingly choosing the most effective form of contraception and are demonstrating more responsibility in their sexual behaviour.
Doctors say that implants, which are fitted under the skin of an arm, have higher success rates than condoms or the pill. They cost £90 to fit, work for three years and produce better value than the pill after one year, once the cost of abortions and antenatal care are included.
The figures, collected by the NHS Information Centre, are based on visits by 887,500 women and girls to sexual health clinics. They show that of 81,900 who were recorded as using implants this year, more than half were 24 or under.
About 25,100 were teenagers and 4,500 were 15 or younger. The number of 16-19 year olds using implants rose more than six-fold, from 3,100 in 2005 to 20,600,which may be partly due to a slight increase in females of that age visiting clinics in that period.
"Implants are infinitely better at preventing unwanted pregnancy than condoms and over 100 times more effective than the pill," said Peter Greenhouse, a consultant at the Bristol Sexual Health Centre.
Their use is increasing because more nurses have been trained to fit them, there is more education work at schools and sexual health clinics about the best forms of contraception and because local NHS primary care trusts have realised that they are cheaper and more effective than the pill, Greenhouse added.
"The highest take-ups occur where time and money has been spent on marketing the implant and training staff to fit it," said Kate Guthrie, a consultant gynaecologist in Hull, an area with one of the highest rates of implant use.
"In London services are under a lot of pressure and may not be so organised or co-ordinated. In some places GPs still don't take contraception seriously and that means women don't get equal access to contraceptive choices."
Guthrie said the majority of women choosing the implant in her clinic had been in their teens and 20s, but denied that the device – which does not protect against sexually transmitted infections – might encourage irresponsible behaviour or explain the rise in infections.
"Women who are responsible enough to go for this contraceptive will also be smart enough to use a condom for protection against infection," Guthrie said.
"We have too many women coming in for emergency contraception because they've forgotten to take the pill … women are increasingly realising the implant is a smarter choice – it's safe, effective and if they don't like it they can have it taken out. It's a sign that responsibility is going up, not down."
Gillian Vanhegan, a medical spokeswoman for Brook, the sexual health charity that helps under-25s, said the popularity of implants was helping to cut the teenage pregnancy rate.
"We've been striving for increased education and choice for women in schools and clinics for years and finally we're seeing light at the end of the tunnel," she said.
"It's no coincidence that this news comes out at the same time that the lowest teenage pregnancy figures for 20 years were released last week – the two are obviously linked."
The shift towards implants is part of a wider trend. More than 25% of women use long-acting methods of contraception, such as coils, implants and injections, compared to 18% in 2005.
Although the numbers using the injection have decreased slightly, the number of women using the hormone-releasing coil has tripled in five years, making it the primary method of contraception for 4% of all women.
The pill – which is 50 years old this year — remains the most common form of contraception with the proportion of women using it remaining relatively stable over the five years, dropping from 45% to 44%.
In 2005 a review of contraception by the National Institute for Health and Clinical Excellence (Nice) determined that long-acting methods were considerably more cost-effective because they dramatically reduced the pregnancy rate.
"Condoms didn't figure in the Nice analysis because they have such a high failure rate," said Greenhouse. "Failure rates are up to 10% in adults and even higher in teenagers – they can't really be considered as an appropriate contraceptive choice for women who genuinely don't want to conceive".
Unlike condoms or the pill, implants are invisible. That may help explain their popularity, as some teenagers may choose it so that parents do not know they have a regular form of contraception.
"It [the implant] is very discreet, and is a method that could be used by someone who didn't want others knowing they were using it," said Vanhegan. "These methods and the injection are often used by women in domestic violence situations who are scared of getting pregnant."
The NHS report shows that highest rate of implant use occurs in the south-west, where 16% of women rely on them, compared with 21% using condoms and 38% on the pill. The lowest uptake is in London, with 5%, compared to 26% using condoms and 46% on the pill.
Case study
Katy Bairstow, 30, a freelance web developer and graphic designer from Lewisham, in south-east London, had the implant inserted a year ago.
"I heard about the implant by word of mouth – I certainly didn't hear about it at school, and when I contacted my GPa few years ago they had no idea what it was.
When I started a long-term relationship I went to visit a sexual health clinic and asked about it again, and it's a godsend. There's no need to worry about taking the pill every morning, and if we go on holiday last minute there's no need to pack anything.
I thought I'd have some sense of it being there but it's invisible and you can't even feel it. The nurse put it in with local anaesthetic, and it was over and done with in a couple of minutes.
It's also helped with my periods. I've been told the benefits vary from person to person, but since I had the implant fitted I've had no PMS, no cramp – no bleeding at all. I've never had to take it out, and I've told as many people about it as possible.
Young people who aren't in long-term relationships will need to think about condoms as well to protect against sexually transmitted infections, but there's still a benefit of going on this for double protection.
I think the only reason more women don't have it is an awareness issue. A lot of people my age or older haven't heard about it, but I'd like to think younger people get a better education than the 10 minutes I got at school."