What Is A Nexplanon? Definition

Nexplanon is a small, flexible plastic rod about the size of a matchstick that is implanted under the skin of the upper arm to prevent pregnancy. It is a type of long-acting reversible contraception, often called LARC, that releases a steady dose of the hormone etonogestrel. Once inserted, it provides continuous birth control for up to three years, making it one of the most effective contraceptive methods available.

How Does Nexplanon Work?

Nexplanon works primarily by stopping ovulation. The hormone etonogestrel, a progestin, is released slowly into the bloodstream. When levels are high enough, the brain does not send the signal for the ovary to release an egg.

The hormone also thickens the cervical mucus. This makes it harder for sperm to move through the cervix and reach an egg. If ovulation does happen, which is rare, the thickened mucus provides a second layer of protection.

Unlike birth control pills, Nexplanon does not require daily attention. Once it is in place, it works continuously. There is no room for user error, which is why its failure rate is comparable to sterilization. According to the Centers for Disease Control and Prevention, fewer than 1 in 100 women will become pregnant in the first year of typical use.

What Is The Insertion Process Like?

A healthcare provider inserts Nexplanon during a routine office visit. The procedure is quick, usually taking less than five minutes. The provider numbs the area on the inside of the upper arm with a local anesthetic.

A special applicator is used to place the rod just under the skin. Most people feel a small pinch from the numbing injection, but the insertion itself is generally painless. There is no surgical incision. The insertion site is covered with a small bandage and a pressure bandage to reduce bruising.

The rod is left in place for three years. After that, it must be removed and can be replaced with a new one if you want to continue using this method. Removal is also quick and involves a tiny cut after numbing the area.

What Are The Common Side Effects?

The most common side effect of Nexplanon is changes in menstrual bleeding. This is the main reason some women stop using it. Bleeding patterns are unpredictable and vary from person to person.

Some women have no periods at all. Others have light, irregular bleeding. A smaller number experience frequent or prolonged bleeding. The bleeding pattern you have in the first three months often indicates what you can expect long term, but it is not a guarantee.

Other reported side effects include headaches, weight gain, breast tenderness, and mood changes. Research on these symptoms is mixed. Some studies suggest a link, while others show no difference compared to women not using hormonal birth control. If you experience side effects, they often improve after the first few months as your body adjusts to the hormone.

What Are The Serious Risks?

Serious complications from Nexplanon are rare but possible. The most concerning is the rod migrating, meaning it moves from the insertion site. This is uncommon, and it is why the rod is placed just under the skin where it can be felt. If you cannot feel the rod, contact your provider immediately.

Blood clots are a risk with any estrogen-containing birth control. Nexplanon is progestin-only, so the risk of blood clots is lower than with combined pills. However, the risk is not zero. If you have a history of blood clots in your legs or lungs, Nexplanon may not be safe for you.

Infection at the insertion site is rare but can happen. Signs include increasing pain, redness, swelling, or discharge. If the rod breaks or bends, which is very rare, it may need to be removed surgically.

There is also a small risk of the rod being inserted too deeply. If this happens, it may not be palpable, and imaging such as ultrasound or X-ray is needed to locate it. This is why it is critical to have the rod inserted by a trained provider.

How Effective Is Nexplanon Compared To Other Birth Control?

Nexplanon is one of the most effective reversible birth control methods available. Its typical-use failure rate is less than 1 percent. This means it is more effective than birth control pills, the patch, and the vaginal ring, which have typical-use failure rates around 7 to 9 percent.

It is comparable to intrauterine devices (IUDs) and permanent sterilization. The main difference is that Nexplanon does not protect against sexually transmitted infections. Only condoms reduce the risk of STIs.

Effectiveness also depends on weight. Some research suggests that etonogestrel levels may be lower in women who weigh more than 70 kilograms, roughly 154 pounds. Clinical guidelines still consider Nexplanon effective for heavier women, but the evidence on this is not fully settled.

Who Should Not Use Nexplanon?

Nexplanon is not right for everyone. You should not use it if you are pregnant or think you might be. It is also not recommended if you have liver disease, unexplained vaginal bleeding, or breast cancer, now or in the past.

Women with a history of blood clots in the legs or lungs should discuss this with their provider. While progestin-only methods carry a lower clot risk than estrogen-containing methods, the risk is not absent.

Certain medications can reduce the effectiveness of Nexplanon. These include some anti-seizure drugs, the herb St. John’s Wort, and certain HIV medications. If you take any of these, talk to your provider about whether Nexplanon is still a good option.

What Happens When Nexplanon Is Removed?

When the three years are up, or if you decide you want to become pregnant, the rod is removed. The procedure is similar to insertion. The provider numbs the area, makes a tiny cut, and pulls the rod out.

Fertility returns quickly after removal. There is no delay in your ability to get pregnant. Most women ovulate within the first month after the rod is removed.

If you do not want to get pregnant, a new rod can be inserted immediately during the same visit. This provides uninterrupted contraception.

What Is A Nexplanon And How Does It Differ From Implanon?

Nexplanon is the newer version of Implanon. Both contain the same hormone and are equally effective. The main difference is the applicator. Nexplanon uses a pre-loaded, single-use applicator that makes insertion easier and reduces the risk of deep insertion.

Nexplanon is also visible on X-rays, which Implanon was not. This is because Nexplanon contains a small amount of barium sulfate. This helps locate the rod if it ever needs to be found for removal.

If you hear someone refer to “the arm implant,” they are almost certainly talking about Nexplanon or its predecessor. In the United States, Nexplanon is the only contraceptive implant currently available.