What is Nexplanon aka The Implant?

Nexplanon is a small, flexible plastic rod, about the size of a matchstick, that is inserted just beneath the skin on the inner side of the upper arm. It is inserted and removed by a healthcare provider during a simple in-office procedure. The implant releases a low, steady dose of progestin (etonogestrel), can remain in place for up to 3 years and is more than 99% effective at preventing pregnancy. Nexplanon does not contains estrogen. Nexplanon is a LARC method which stands for Long Acting Reversible Contraceptive. Nexplanon also contains a small amount of barium sulfate which allows it to be seen more easily by x-ray.

How does Nexplanon work?

  • It primarily prevents pregnancy by stopping ovulation (the release of an egg the ovaries)
  • Thickens the mucus in the cervix which helps keep sperm from reaching the egg
  • Thins the lining of the uterus

Who is a suitable candidate for Nexplanon?

  • Are not pregnant
  • Have no history of or current breast cancer
  • Have no history of progesterone sensitive cancer such as ovarian, uterine
  • Have no liver tumors or active liver disease
  • Have no undiagnosed abnormal genital bleeding
  • Have no current or past history of thrombosis (blood clots) or thromboembolic disorders.

What are the Benefits/Advantages of Nexplanon?

  • Nexplanon is highly effective- 99+% effective. This means that if 1000 people use as their only form of pregnancy prevention for one year, less than 1 will become pregnant. This is similar to using a hormonal IUD (Kyleena or Mirena)
  • Continuous protection for up to 3 years
  • Private and discreet and user has control over its use
  • Most users experience an improvement in their cycle bleeding patterns and cramping
  • Rapid return to fertility after removal

What are Common Side Effects of Nexplanon?

  • Unpredictable bleeding is commonly experienced during the 1st year after insertion. This can range from no bleeding to spotting, to prolonged bleeding. 1 out of every 10 users stop using the implant because they are unhappy with the bleeding pattern. However, over 50% of users will have little or no bleeding after Nexplanon is inserted.
  • 5-15% chance of side effects including: headache, weight gain, acne, breast pain, mood changes, and abdominal pain

What are the Risks/Disadvantages of Nexplanon?

  • Insertion may cause discomfort, swelling and bruising at the insertion site
  • It is possible for the implant to be inserted too deep or to migrate from the original placement
  • If you or your healthcare provider are unable to feel the implant at ANY time, it should be located with imaging (x-ray etc) and removed. Sometimes this requires surgery. 
  • Nexplanon does not protect against sexually transmitted infections (STIs). We always recommend that people use a barrier (condom/glove/dam) method during sex and we encourage you and your partner(s) to be tested regularly.

How does Nexplanon compare to the other LARCs (long-acting forms of contraception)?

How is Nexplanon inserted?

  • The implant is placed under the skin of your upper arm using a special insertion tool. Freezing is injected where the implant will be inserted. You will feel the injection of the freezing but should not feel the insertion of the implant.
  • After the insertion you may notice some redness, pain, bruising or swelling at the site of the implant which should resolve over time.

How is Nexplanon removed?

  • After injecting a small amount of freezing, the healthcare provider will make a small incision at the site before removing the implant. Some minor bruising, redness, swelling and/or pain may occur at the site. Removals of inserted implants can cause scarring.

Do any other medications interact with Nexplanon?

  • Some medications or herbal products that may decrease the effectiveness of Nexplanon include: efavirenz, phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicine, topimarate, rifabutin, rufinamide, aprepitant, and products containing St. John’s wort.
  • If you are not sure if the medication you are taking interferes with Nexplanon, call a pharmacy or our clinic and use a back-up method (condoms).

How do I get Nexplanon inserted?

  • Nexplanon is accessed through prescription at our clinic or pharmacies. Although a person can obtain Nexplanon through a pharmacist, it must be inserted and removed by a trained healthcare professional
  • Call (250) 592-3479 to book an appointment for a Nexplanon consultation appointment. During this appointment you will receive more information about Nexplanon and its suitability for you. If it’s determined that Nexplanon would be suitable for your needs, you will be offered a prescription that you will have filled in a pharmacy previous to your insertion appointment as you will need to bring the device with you to your insertion appointment.

How quickly after insertion does Nexplanon become effective?

It takes 7 days after insertion for Nexplanon to become effective in the prevention of pregnancy. You can either choose not to have sex for the first 7 days following insertion to avoid pregnancy or use an additional birth control method for the first 7 days.

When should I contact the clinic following a Nexplanon insertion?

  • If you experience prolonged pain, redness, swelling, bleeding or discharge at the insertion site (this may be a sign of infection)
  • If you have reason to suspect pregnancy
  • If you cannot feel the implant under your skin
  • If you are experiencing unexplained side effects/symptoms that are concerning to you