Birth control
Implant (Nexplanon)

Birth Control

Implant (Nexplanon)

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What is the implant (Nexplanon)? The implant might be for you if... How do you use the implant? How much does the implant cost? What are the side effects and benefits of the implant? Where can you get the implant?

What is the implant (Nexplanon)?

The implant (Nexplanon and its generic versions) is a small rod, about the size of a matchstick, that’s inserted under the skin of your upper arm (after you get numbing medication!). Once it’s inserted, it’s not visible in most cases.

The implant slowly releases a single hormone, progestin, that prevents pregnancy primarily by thickening cervical mucus, making it harder for sperm and egg to meet. It’s FDA-approved to prevent pregnancy for up to three years, but research shows it’s effective for up to five years. You can always get it removed sooner if you want to.

Quick Facts

Super effective, lasts for years, low-maintenance, and private.

Effectiveness

The implant is super effective—one of the most effective birth control methods.

Perfect use: Over 99% effective

Typical use: Over 99% effective

What are perfect use and typical use?
Hormones

The implant contains the hormone progestin.
Side effects

Irregular bleeding is the most common side effect.
Cost

Could range from $0 (with insurance) to $1300. There may be an extra cost for insertion and removal.
STI protection

The implant doesn’t protect against STIs.
Ongoing effort

Once it’s in, there’s nothing for you to do. You can keep it in for up to five years with no ongoing effort.

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The implant might be for you if...

Effectiveness at preventing pregnancy is a top priority for you.

The implant is over 99% effective at preventing pregnancy. That means that, on average, fewer than one out of every 100 people who use the implant for a year will get pregnant.

You don’t want to have to remember anything for your birth control to work.

The implant is great if you don’t want to have to worry about taking a pill every day or switching out a ring or patch. Once the implant is in, you’re good to go for up to five years. (And you can always get it taken out before then if you want.)

You don’t mind changes to your period.

Most people who get the implant have fewer, lighter periods. But some people have irregular bleeding, which may mean spotting or bleeding in between periods or having longer, heavier periods. If you do have irregular bleeding as a side effect, it may continue the entire time you have the implant.

You aren’t looking for STI protection, or you’re okay with combining the implant with another method.

The implant doesn’t offer any STI protection. If you’re looking for STI protection, you can use condoms or internal condoms along with your implant. Dental dams and/or gloves can also offer STI protection, depending on what kind of sex you’re having. You may also want to consider PrEP (pre-exposure prophylaxis), which is a daily pill or an injection you can get every two months to decrease your risk of getting HIV.

You want a method that won’t affect your future fertility.

The only birth control method that permanently affects your future fertility is sterilization. The implant does not affect your ability to get pregnant after you stop using it. In fact, soon after you have the implant removed, your body will return to whatever level of fertility is normal for you. That means you could get pregnant soon after you have the implant removed. If you’re not ready to get pregnant right after getting your implant taken out, you’ll need to use an alternative method.

You don’t mind a method that requires a visit to your health care provider.

The implant is inserted and removed by a health care provider. Your provider should always remove your implant right away when you ask for it to be removed, but some people may feel uncomfortable with needing a provider’s involvement to stop their birth control. Unlike with the IUD, you can’t take matters into your own hands and remove the implant yourself.

You don’t need to hide your method.

Once you have the implant placed and any bruising on your arm fades, it probably won’t be visible to other people because it’s under your skin. However, if someone is looking for it, they may be able to spot a raised area where the implant is sitting.

You will be able to feel the implant when you press on the area where it’s located. It’s actually good, medically speaking, to be able to feel it with your fingers—if you ever can’t feel it, you should speak to your provider to make sure everything’s okay—but some people may feel uncomfortable with the idea of feeling something under their skin.

If you need to keep your birth control private, keep in mind that you may not be able to completely hide that you have an implant from people close to you, especially people who might touch your arm.

You don’t have this risk factor.

Don’t use the implant if you currently have breast cancer. The implant is not the safest option for you and you’ll need to talk with a provider about your health before getting it If you have a history of breast or liver cancer or unexplained vaginal bleeding. If you have heart disease or have a stroke, talk to your provider about if it’s safe for you to continue using the implant.

How do you use the implant?

The implant prevents pregnancy by slowly releasing a small amount of progestin, a hormone that primarily works to prevent pregnancy by thickening cervical mucus, which makes it harder for sperm and egg to meet. Once the implant is inserted, it just sits there, under your skin, offering protection against pregnancy for up to five years.

To get the implant, first you visit a health care provider, and they get some medical info from you. Then they will give you a shot of numbing medicine under your skin where the implant will be placed. Then the health care provider will insert the implant under your skin, using a special tool made just for this purpose. While you’ll feel the numbing shot, which will sting and burn when the medicine goes in, you should not feel pain when the implant goes in.

It’s important to visit a health care provider who has been trained in inserting implants. It is completely okay to ask your provider how much experience they have with inserting the implant.

You’ll be set for pregnancy prevention from the moment you get the implant if any of these things are true for you:

You are getting the implant during the first five days after your period starts.
You were already using a hormonal method of birth control consistently before getting the implant.
You had a miscarriage or abortion within the last seven days.
You gave birth within the last 21 days.

If none of those things are true for you, then you’ll need to use a backup method of birth control, like condoms or internal condoms, for seven days after getting your implant.

When it’s time to take the implant out, your provider will give you a shot of numbing medicine in the area of your arm where the implant is located, make a tiny cut in your skin, and remove the implant. If you want to keep using the implant as your birth control method, they can put a new one in at the same time.

How much does the implant cost?

With insurance

If you have health insurance—whether it’s from work, school, your parents, the ACA marketplace, or Medicaid—chances are good that you’ll be able to get this method with no out-of-pocket cost.

Without insurance

If you don’t have insurance or if you’re on a plan that doesn’t cover birth control, the implant can cost up to $1,300, plus any additional costs for insertion. Depending on your income, you may be able to go to a low-cost clinic to get the implant at a reduced cost. Check with your local family planning clinics to find out if they offer free or low-cost implants (many do).

What are the side effects and benefits of the implant?

There are positive and negative things to say about each and every method. And everyone’s different—so what you experience may not be the same as what someone else experiences.

The Positive

There are many things about the implant that are good for your body as well as your sex life. Here are some of the benefits of the implant:

It doesn’t interrupt the heat of the moment.
Most implant users have fewer, lighter periods.
You don’t have to remember to do anything for your birth control to work for five years.
It’s safe for smokers and those with hypertension and diabetes.
It can be used while breastfeeding.
It can be used by people who can’t take estrogen.
It may improve PMS and endometriosis symptoms.

The Negative

It’s normal to think about side effects, but for many people, they’re not a problem. Most people using the implant who experience side effects find that they go away with time. It can take a few months to adjust.

The most common side effect of the implant is irregular bleeding, which for some people does not get better over time and continues for as long as they have the implant. This could mean spotting in between periods or having longer, heavier periods. Some people have irregular bleeding the whole time the implant is in. Other people get no periods at all, at least for a while. It’s unpredictable how the implant may affect your period. The bottom line is that if it’s important to you to have a regular period every month, the implant is probably not right for you.

Less common side effects:

Acne
A change in your appetite
A change in your sex drive
Ovarian cysts
Anxiety and/or depression
Discoloration or scarring of the skin over the implant
Dizziness
Hair loss
Headache
Nausea
Pain where the implant was inserted
Sore breasts

A very small number of people experience serious side effects like the implant moving from where it was placed, nerve injury, or difficulty removing the implant.

In addition to potential side effects, there are some disadvantages to using the implant:

It may not be possible to hide it completely.
You have to see a provider in person to start using the implant.
A provider has to remove it, so you can’t just stop using the implant on your own.
It doesn’t protect against STIs.

Where can you get the implant?

The implant needs to be inserted by a health care provider. Make an appointment at a health center.