What is “the Implant”?
Nexplanon is a progestin-only, hormonal contraceptive implant that provides continuous birth control lasting up to 3 years. It is roughly the size of a matchstick (4 x 2 mm) and is inserted by your doctor just under the surface of your skin in your inner, upper non-dominant arm. You will be able to feel it under your skin but no one will be able to see it!
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How does the Implant work?
It prevents pregnancy by stopping ovulation (the release of an egg from the ovary). It thickens the mucus around the cervix. This prevents sperm from entering the cervix and alters the lining of the womb to inhibit implantation of the pregnancy.
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How effective is the Implant?
Nexplanon is more than 99% effective. Of every 1,000 women who use this method, 3 will become pregnant during first year of use. This is one of the most effective forms of birth control. The only method more effective is abstinence!!
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Am I a good candidate for the Implant?
Nexplanon is worth considering if you want long-term contraception without following a daily routine. Since protection is maintained for 3 years, it allows for sexual spontaneity. It may also be a good choice for you if you cannot remember take a pill everyday or if you cannot use birth control containing estrogen (i.e. you are over 35 and a smoker or have a history of blood clots.). The implant does not protect from sexually transmitted diseases particularly HIV. If this is a concern you should use a condom as well.
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Are there any reasons why I shouldn’t use the Implant?
Most women of any age needing birth control can use NEXPLANON. You should not use Nexplanon if you have a history of:
- active liver disease
- current or past history of breast cancer
- unexplained vaginal bleeding
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What are the common side effects of the Implant?
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| irregular bleeding |
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The most common side effect of Nexplanon is a change in your normal menstrual bleeding pattern. In studies, one out of ten women stopped using the implant because of an unfavorable change in their bleeding pattern. You may experience longer or shorter bleeding during your periods or have no bleeding at all. The time between periods may vary, and in between periods you may also have spotting.
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Besides changes in menstrual bleeding patterns, other frequent side effects that cause women to stop using the implant include:
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| headache |
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| weight gain |
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| nausea |
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What are the benefits of the Implant?
- easy to use—once the implant is placed you are good to go!
- extremely reliable—this form of birth control has one of the lowest failure rates
- confidential--no one other than your health care provider needs to know you are using it
- decreases menstrual cramps and blood loss
- reversible—once removed your regular cycle will quickly return
- protective effect in reducing the risk of endometrial cancer
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When can I have the Implant placed?
Nexplanon is placed and removed as a minor surgical procedure in your doctor’s office. It is inserted just under the skin on the inner side of your upper arm. The timing of insertion is important. Your health care provider may:
- Perform a pregnancy test before inserting Nexplanon
- Schedule the insertion within the first 5 days of your period
- If at any other time in your cycle, use a backup for 2 weeks
If placed at a different time in your cycle, use a backup method for the next 2 weeks. Immediately after the Nexplanon implant has been placed, you and your doctor should check that the implant is in your arm by feeling for it. The site where Nexplanon was placed will be covered with 2 bandages. Leave the top bandage on for 24 hours. Keep the smaller bandage clean, dry, and in place for 3 to 5 days.
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What are the possible risks of the insertion and removal procedure?
The implant may not be placed in your arm at all due to a failed insertion. If this happens, you may become pregnant. Immediately after insertion, you should be able to feel the implant under your skin. If you can’t feel the implant, tell your doctor. Removal of the implant may be very difficult or impossible because the implant is not where it should be. Special procedures, including surgery in the hospital, may be needed to remove the implant. If the implant is not removed, then the effects of NEXPLANON will continue for a longer period of time. Other problems related to insertion and removal are:
- pain, irritation, swelling, or bruising at the insertion site
- scarring, including a thick scar called a keloid around the insertion site
- infection
- scar tissue may form around the implant making it difficult to remove
- the implant may come out by itself. You may become pregnant if the implant comes out by itself. Use a back up birth control method and call you health care provider right away if the implant comes out
- the need for surgery in the hospital to remove the implant
- injury to nerves or blood vessels in your arm
- the implant breaks making removal difficult
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Are there any warning signs I should look out for after placement of the Implant?
Call your doctor if you have any of the following problems:
- pain in your lower leg that does not go away
- severe chest pain or heaviness in the chest; sudden shortness of breath, sharp chest pain, or coughing blood
- symptoms of a severe allergic reaction, such as hives, swollen face, tongue or pharynx, trouble swallowing or breathing
- sudden severe headaches unlike your usual headaches; weakness or numbness in your arm, leg, or trouble speaking
- sudden partial or complete blindness
- yellowing of your skin or whites of your eyes, especially with fever, tiredness, loss of appetite, dark colored urine, or light colored bowel movements
- severe pain, swelling, or tenderness in the lower stomach (abdomen)
- lump in your breast
- problems sleeping, lack of energy, tiredness, or you feel very sad
- heavy menstrual bleeding
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Is the Implant covered by my insurance?
With the Affordable Care Act, contraceptive devices such as Nexplanon should be covered with no out-of-pocket expense. I would still recommend that you verify this with your insurance company. When you call your insurance company, use the following CPT codes: Nexplanon device (J7307) and Nexplanon insertion (11981).
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