Nexplanon Birth Control Implant – What to Expect

What Is Nexplanon?

Nexplanon is a small, flexible birth control implant (about the size of a matchstick) that is placed under the skin of your upper arm by a healthcare provider. It steadily releases a progestin hormone (etonogestrel) into your bloodstream to prevent pregnancy. The hormone works by stopping ovulation (so no egg is released) and thickening the cervical mucus, which blocks sperm from reaching any egg. Nexplanon provides long-acting pregnancy prevention for up to 5 years[1] with a single implant.

One big advantage of Nexplanon is that it’s “get-it-and-forget-it” contraception. Once inserted, you don’t have to do anything daily or weekly to maintain its effectiveness. Nexplanon is over 99% effective, making it one of the most reliable birth control methods available[2]. Fewer than 1 in 100 people using Nexplanon will get pregnant each year[2] – which is about as good as it gets for birth control. Its effectiveness is so high largely because it removes the possibility of user error (you can’t forget to take it or use it incorrectly).

Insertion and Removal Procedure

A doctor or nurse must insert and remove the Nexplanon implant. Insertion is a quick in-office procedure. First, your provider will numb a small area on the inner side of your upper arm. Then they use a special applicator to slide the tiny rod under your skin. The procedure only takes a few minutes and is generally not painful (aside from a little pinch from the numbing shot). After insertion, you might experience some soreness, tenderness, or bruising at the site for a few days. The implant isn’t usually visible – it can be felt as a small bump under the skin, but not easily seen.

Nexplanon prevents pregnancy immediately if it’s inserted within the first 5 days of your menstrual period. If it’s inserted at any other time in your cycle, you’ll need to use a backup birth control method (like condoms) for 7 days until the implant’s hormone kicks in fully.

A single Nexplanon implant works for up to 5 years, after which it must be removed or replaced by a healthcare provider[1]. Removal is also a quick procedure: the provider numbs the area, makes a tiny incision, and pulls out the rod. Fertility returns rapidly after removal – you can potentially get pregnant right away once Nexplanon is taken out. If you still want to prevent pregnancy, you can have a new implant placed during the same visit as the removal. Remember, the implant doesn’t protect against sexually transmitted infections, so you’ll still need condoms to prevent STIs.

Benefits of Nexplanon

Nexplanon offers several benefits that make it an attractive option for many women:

• Highly Effective: With a >99% effectiveness rate, it’s one of the most reliable methods available[2]. It’s comparable to the effectiveness of IUDs for pregnancy prevention.
• Long-Lasting: One implant provides protection for up to five years. You don’t have to think about birth control daily, weekly, or even monthly.
• Convenient: It’s a “set it and forget it” There’s no need to remember a daily pill or schedule frequent clinic visits (after the insertion, it just needs replacement at or before 5 years).
• Reversible: It can be removed at any time if you decide you want to become pregnant or switch methods. Your ability to get pregnant comes back quickly after removal.
• Estrogen-Free: Nexplanon uses a progestin hormone only. This makes it a good option for those who cannot take estrogen-based birth control (for example, breastfeeding mothers or women with certain health risks). It’s safe to use while breastfeeding (usually insertion is done after 4-6 weeks postpartum, as advised by your doctor).
• May Reduce Periods: Many users find that their periods become lighter or even stop entirely while on the implant. In fact, about 1 in 3 people stop having periods after a year of use (which is a harmless side effect). This can be a positive benefit for those who have heavy or painful menstrual cycles.

Potential Side Effects and Considerations

As with any hormonal birth control, Nexplanon can cause side effects in some people. Changes in menstrual bleeding patterns are the most common. You might have irregular bleeding or spotting, longer or shorter periods, or even no periods at all. These changes are usually not dangerous, but unpredictable bleeding can be annoying. In studies, about 1 in 10 women ended up removing the implant due to unfavorable changes in their bleeding pattern. Often, these issues improve over time as your body adjusts, but if prolonged heavy bleeding occurs, you should inform your healthcare provider.

Other possible side effects include: headaches, acne, breast tenderness, mood swings, and weight gain. Many people do not experience major problems, but if you do have side effects, they often ease up after the first few months. For example, some users report a small amount of weight gain or changes in appetite – on average, clinical trials found a slight weight increase in some patients (individual experiences vary). If the side effects are bothersome or don’t improve, you can talk to your provider; remember, you can have the implant removed at any time if needed.

It’s also important to know that certain medications or supplements might make Nexplanon less effective. For instance, the antibiotic rifampin (used for tuberculosis) or some anti-seizure medications can lower its effectiveness. Always let your healthcare provider know about any drugs you’re taking.

Finally, Nexplanon does not protect against STDs (sexually transmitted diseases). You’ll still need to use condoms for STD protection. Nexplanon is a great contraceptive for pregnancy prevention, but for safer sex, condoms are essential.

Who should not use Nexplanon? Generally, most healthy women can use it. However, it’s not recommended if you have certain conditions like active breast cancer, unexplained vaginal bleeding, or severe liver disease. Your doctor will review your medical history to ensure the implant is safe for you. Nexplanon is a progestin-only method, so unlike combined birth control pills, it’s often permissible even for women who are older or who smoke, etc., but always follow medical advice based on your personal health profile.

Possible side effects of Depo-Provera include irregular menstrual bleeding, headaches, and bloating. Similarly, hormonal implants like Nexplanon can cause side effects such as changes in periods, headaches, or weight changes in some users.

FAQs about Nexplanon

Does Nexplanon insertion hurt?

The procedure is quick and generally not painful. You’ll receive a numbing injection in your arm, so you mostly feel only a little pinch or sting from that shot. After that, you shouldn’t feel the implant being inserted. Your arm may be a bit sore or bruised for a couple of days afterwards, but serious pain is uncommon.

Will Nexplanon cause me to gain weight?

Some people do experience weight gain or increased appetite on Nexplanon, but it varies. Clinical data shows weight gain was a reason some users stopped using the implant, but not everyone will gain weight. If it occurs, the gain is often modest (a few pounds). Maintaining a healthy diet and exercise can help manage any potential weight changes.

What happens to my periods on Nexplanon?

Your period will likely change. Many users have irregular spotting or bleeding, especially in the first 6-12 months. Some have longer periods, others have shorter or lighter ones. About 30% of users stop getting a period at all after the first year, which is a normal effect of the hormone. These changes are generally safe, but if you’re ever concerned (for example, if you have very heavy or nonstop bleeding), check with your healthcare provider.

How soon can I get pregnant after removing Nexplanon?

Quickly – potentially right away. The hormones from the implant leave your system very fast once it’s removed. In fact, Nexplanon users can ovulate as early as 7-14 days after removal, meaning it’s possible to become pregnant in the first month after removal if you’re not using another method. If you don’t want to get pregnant immediately after removal, make sure to start another reliable birth control method.

Can the implant move or get “lost” in my arm?

It’s very rare for Nexplanon to migrate from the insertion spot. In the vast majority of cases, it stays put in the upper arm where it was inserted. There have been a few reports of implants moving slightly or being found in a blood vessel (extremely uncommon), but this is not typical. As long as a trained provider inserts it correctly, it should be easy to feel under your skin. Always have removal done by a trained provider as well – they know how to locate it. Don’t try to mess with the implant on your own.

Is Nexplanon safe for everyone?

Nexplanon is safe for most women and even teenagers. It can be used safely while breastfeeding (it doesn’t affect milk supply) and is often offered to postpartum moms. However, if you have certain health conditions (like active breast cancer, some liver diseases, or history of serious blood clots), your provider may advise against it. Always discuss your full medical history. For most users, the implant is a well-tolerated and convenient option for long-term birth control.