Nexplanon Implant: Is the Most Effective Birth Control on the Market Right for You?
Dr. Angel Rivera
Nexplanon is the newest form of long-acting reversible contraception (LARCs) that provides pregnancy prevention for up to three years. Nexplanon replaced the contraceptive implant Implanon in 2010. Unlike Implanon, Nexplanon is radiopaque, which means it is visible through x-ray. Nexplanon is over 99% effective and is the most effective reversible contraceptive available at this time. The best part is that once it's inserted, you won’t have to think about pregnancy prevention again. No need to remember to take a daily pill, purchase costly condoms, or make inconvenient trips to the pharmacy like with many other birth control methods. Nexplanon is also a safe option with the most common side effects leaning towards unpleasant rather than life-threatening. While the "best" birth control is the one that does its job effectively - is Nexplanon the best option for you?
What is the Nexplanon Birth Control Implant?
Nexplanon is a thin, rod-shaped device comparable to the size of a matchstick. It is inserted just under the skin of the inner upper arm by a healthcare professional.
Nexplanon contains the hormone progestin. Progestin is released by the device into the bloodstream over the course of implantation. It works similarly to other methods by stopping the ovaries from releasing an egg (ovulation) and preventing sperm from reaching the egg by thickening the cervical mucus. It also changes the lining of the uterus to make fertilization difficult.
Nexplanon is a reversible form of birth control. At any point, the implant can be removed from the arm much in the same way that it was inserted. After removal, pregnancy can occur as soon as within a week. At the end of the three-year timeframe, if pregnancy prevention is still needed, you can simply have the implant removed and a new one reinserted at the same time.
*It is important to note that recent research has proven that the implant is effective for four to five years, longer than the initially thought three years. FDA prescribing information still maintains that the implant should be removed at the end of three years, but it is worthwhile to discuss with your provider and make the best decision for your health.
Side Effects of Nexplanon
The most common side effect of Nexplanon is a change in menstrual bleeding patterns. This can mean longer or shorter periods, spotting between periods, or no bleeding at all. It is very common for periods to decrease and become lighter and stop completely while on Nexplanon.
Unfortunately, irregular bleeding can be a frustrating side effect and is a frequent reason women get the implant removed. Spotting can occur anywhere from 6 months to a year after insertion and usually subsides with many women having no periods (which can be a welcome side effect).
Other common side effects include:
- Mood swings or depressed mood
- Vaginal itching or discharge
- Weight gain
- Back, stomach, and breast pain
If side effects become severe or affect your quality of life, contact your healthcare provider.
What To Expect With the Nexplanon Birth Control Implant
The Nexplanon implant is a quick and minimally invasive procedure easily done in your doctor’s office. Nexplanon is inserted into the subdermal area on the inner aspect of the upper, nondominant arm. The area is first cleansed with an antiseptic then injected with an anesthetic. This initial injection may cause pinching or burning but after the anesthetic takes effect you won’t be able to feel the insertion of the implant. The implant is then guided under the skin using an applicator. There may be slight bleeding, but the area will be covered with a pressure bandage and you will need to keep the area dry for the first 24 hours. After removing the bandage the incision site may still be covered with an adhesive bandage that should be left in place for another 3 to 5 days.
Immediately following the insertion of the implant you and your healthcare provider should check to make sure the implant can be felt by lightly touching the area of the insertion site. You should be able to feel a lump approximately an inch and a half long. Depending on your body composition, you may even be able to see a faint outline under the skin. Periodically check to make sure you can feel the implant, and if you cannot it may have shifted and you should contact your healthcare provider immediately. This can place you at risk for pregnancy if the implant isn’t able to release progestin properly, so a backup form of birth control is recommended until it is verified that your implant is in the correct position.
It is normal to have soreness and swelling for a couple of days following the procedure. Bruising is also normal for another week or so. If these symptoms don’t resolve or are accompanied by any signs of infection (fever, chills; redness, drainage, or odor at the incision site) contact your doctor immediately.
Removal of the implant is very similar to the insertion. The skin is prepped by cleansing with an antiseptic and then numbed with the injection of an anesthetic. A tiny incision will be made at the distal end (closest to the elbow) and the end of the implant should protrude from the incision. The provider should be able to easily pull the implant out. Sometimes tissue can grow around the implant making removal trickier, but your provider will simply cut away the tissue to grasp the implant.
You can have a new implant inserted at the time of removal, often in the same arm, but sometimes may need to be placed in the opposite arm. If you will not be having another implant inserted, but are still wanting to prevent pregnancy, another form of birth control must be started immediately.
Cost of the Nexplanon Implant
The cost of Nexplanon depends on your insurance. The Affordable Care Act is mandated to cover contraceptive methods for women as prescribed by a doctor. This can make Nexplanon free for you. It is still advised to check with your individual health plan, as insurance plans are only required to cover one option in each category (hormonal methods, barrier methods, implanted devices, etc).
The list price for the Nexplanon implant is $981.56. Your out-of-pocket cost will vary depending on your insurance. Keep in mind there may also be costs associated with insertion and removal of the implant. Overall, Nexplanon is a cost-effective method compared to other forms of birth control that have an ongoing or monthly cost such as with condoms or birth control pill prescriptions.
The Nexplanon implant is a newer birth control option that makes pregnancy prevention one less thing to worry about. It is a great option for women looking for a long-term method that’s easily reversible yet highly effective. Nexplanon offers discreet protection with no trips to the pharmacy, no worries about missing a pill, and no risk-taking when you realize you’ve run out of condoms at the moment when they’re needed. Contact your healthcare provider for further guidance to see if the most effective contraceptive is right for you.