Nexplanon: What to expect from the implant birth control
Nexplanon is a small, flexible rod that a clinician places under the skin of your upper arm. It slowly releases etonogestrel, a progestin that prevents pregnancy. The implant lasts up to 3 years and is more than 99% effective when placed correctly — pregnancy risk in the first year is very low.
How insertion and removal work
The clinic visit is quick. The provider numbs a small area on your inner arm, makes a tiny incision, slides the 4 cm implant under the skin and covers it with a sterile bandage. Removal is similar: a small cut, the rod is pulled out, then closed. Both procedures usually take only a few minutes. Expect some soreness or bruising for a few days.
If Nexplanon is put in during the first five days of your period, you’re protected right away. If it’s inserted at another time, use a backup method (condoms or spermicide) for 7 days. Ask your clinician for the exact timing for your situation.
What people commonly notice
Bleeding changes are the most common effect. Some people stop having periods, others have lighter cycles, and some get irregular spotting or longer bleeding. Mood swings, acne, breast tenderness, and slightly altered libido happen for some users. Serious problems are rare, but let your clinician know if you have severe arm pain, signs of infection at the insertion site, or suspect pregnancy.
Certain medicines can make Nexplanon less effective. Enzyme-inducing drugs — like rifampin, some anti-seizure medicines (phenytoin, carbamazepine), certain HIV drugs, and herbal St. John's wort — can lower hormone levels. If you take those, talk about backup contraception or alternative methods.
Who shouldn’t get Nexplanon? If you’re pregnant or have current breast cancer, it’s not recommended. Also tell your provider about liver disease, unexplained vaginal bleeding, or a history of deep vein thrombosis so they can advise you properly.
Cost and coverage vary. Many insurances cover the device and insertion. Title X clinics and family planning centers often offer low-cost options or sliding-scale fees. Ask about removal costs too — some clinics charge separately.
Thinking about Nexplanon? Prepare a short list of questions: How long do you plan to use it? What side effects are most likely for you? Which medicines you take that might interfere? That conversation helps pick the best option.
If you want a long-acting, reversible method that doesn’t require daily attention, Nexplanon is a strong option. Schedule time with a provider who does insertions so you can get advice tailored to your health and lifestyle.
