Contraceptive Implant

What is a contraceptive implant?

A contraceptive implant (birth control implant) is a small, flexible rod-like device that your provider inserts under your skin in your inner, upper arm. It releases a steady dose of the hormone progestin into your bloodstream to prevent pregnancy for three years. Nexplanon© is the brand name of the birth control implant. A healthcare provider must insert and remove a birth control implant. Birth control implants are one of the most effective forms of birth control available.

How big is it?

The implant is about 1.6 inches (in) long (4 centimeters, or cm) and approximately one-eighth inch in diameter. It’s flexible (you can bend it) and about the size of a matchstick.

How does the birth control implant work?

The implant releases a slow, steady dose of progestin (a hormone) into your body. Progestin prevents your ovary from releasing an egg (ovulation). It also thickens the mucus in your cervix, which makes it hard for sperm to reach an egg (in the rare chance ovulation happens). Progestin also thins your uterine lining, making it difficult for a fertilized egg to implant.

The birth control implant is effective for up to three years.

How effective is a birth control implant?

The birth control implant is one of the most effective options available (the other being an IUD). Studies show it’s more than 99% effective in preventing pregnancy.

How do they put a birth control implant in?

Your healthcare provider inserts the birth control implant in their office using the following steps:

• You’ll lie down on an exam table with your arm bent at your elbow like a letter “L.”
• They numb the skin of your inner, upper arm with local anesthetic so you don’t feel pain.
• Generally, it goes in your nondominant arm, but your provider will ask you in which arm you’d like it.
• They insert the implant under your skin using a special needle-like device.
• You don’t need stitches, but your provider may place a bandage on top. This also helps with bruising.
• The entire process takes just a few minutes.

Removing an implant

A healthcare provider must remove your birth control implant. The contraceptive implant is currently approved for three years, but there’s evidence that the contraceptive implant works for up to five years. The contraceptive implant can be removed at any time after placement based on your preference. Discuss the timing of removal with your healthcare provider.

Removing an implant involves your provider making a small incision in your skin and removing the implant. Your provider will still numb your arm before the procedure so you don’t feel pain. To remove an implant:

• Your provider will numb your skin with local anesthetic.
• Then, they’ll make a small cut and pull the implant out with small forceps or tweezers.
• You don’t need stitches, but your provider will place a bandage on top.
• This procedure takes a few minutes.

You should never attempt to remove your implant. Only trained providers should insert and remove birth control implants. Once your implant’s out, you’re not protected against pregnancy. Use an alternate form of birth control if you don’t want to become pregnant.

Does it hurt to get a birth control implant?

It may feel uncomfortable for a moment, but it shouldn’t hurt. Some people say the numbing medication feels like a pinch. You may feel soreness or tenderness around the implant for a few days.

When can I get the birth control implant?

Your healthcare provider can put the implant in at any point in your menstrual cycle (as long as you’re not pregnant). If your provider inserts it during the first five days of your cycle, it protects you against pregnancy immediately. If it’s after five days into your cycle, you should use a backup contraception (like a condom) for seven days.

What are the side effects of the birth control implant?

The birth control implant isn’t known to have many side effects. Most side effects subside within a few months. Some of the potential side effects are:

• Spotting or changes in normal menstrual bleeding.
• Headaches.
• Acne.
• Sore breasts.
• Mood swings.

Let your provider know if you have side effects that last longer than a few months. There may be some ways to treat side effects prior to the removal of the device. But your provider can remove your implant at any time and you can try another type of birth control.

What are the pros and cons of the birth control implant?

It’s important to weigh all your options for birth control before making a decision. There are advantages and disadvantages to the birth control implant. Talk to your healthcare provider about the risks and benefits of the implant to decide if it’s right for you.

Advantages of the birth control implant

• It’s currently approved for three years, but effective for up to five years.
• You don’t have to remember to take it daily or change it weekly.
• It doesn’t interfere with sexual spontaneity.
• It’s hidden, so no one can see it.
• It’s safe for people who can’t use estrogen-containing birth control.
• You can use it while you’re breastfeeding (chestfeeding).
• It can reduce heavy menstrual bleeding.
• You can get pregnant immediately after removing the implant.

Disadvantages of the birth control implant

• You may have temporary side effects.
• Your provider has to insert it in their office.
• Your periods may become irregular, heavier, lighter, longer or shorter.
• It may make acne worse.
• It doesn’t offer any protection against sexually transmitted infections (STIs).
• Your provider has to remove it once you’re done with it.
• It may interfere with certain medications and antibiotics.
• There’s a small risk of skin infection at the site of the implant.

Who can use a birth control implant?

The birth control implant is a safe and effective way to prevent pregnancy. However, it may not be for everyone. Tell your provider about your medical history so they can help you decide if a contraceptive implant is right for you. It may not be for you if:

• You take certain medications.
• Have liver disease or breast cancer.
• Have unexplained vaginal bleeding.

Do you get periods with the implant?

Some people stop getting their period with the birth control implant. It’s not harmful to your health not to get a period. However, some people don’t like having irregular or absent periods. Talk to your healthcare provider about what you can expect.

Does birth control implant make you gain weight?

No. Research has shown that weight gain isn’t a direct side effect of the birth control implant. However, some people still report feeling bloated or gaining weight while using the implant.

Is the implant better than the pill?

The birth control implant is more effective than the pill at preventing pregnancy. This is mainly because you don’t have to remember to take the implant like you do with a pill. However, the best birth control is one you’ll use correctly. Some people prefer a daily birth control pill, but others like the convenience of an implant. There are other factors that can affect which birth control method your provider recommends. It’s important to discuss your options with your provider.

Can the implant break in your arm?

It’s rare for the implant to break or bend in your arm. If you’ve been in an accident or experienced trauma to your arm, there’s a small chance it shifts the implant or damages it. If you believe this is the case, please contact your provider as soon as possible.

Can it get lost in your arm?

It’s rare for the implant to get lost in your arm. Once the implant’s in, it’s common for your skin to react by thickening the tissue around the implant in an attempt to heal the area. This is also why it’s sometimes harder to remove the implant.

What’s better, an IUD or an implant?

Only you and your provider can decide what birth control method is best for you. It may come down to your preference or your health history. An IUD and an implant are similar. Some of the similarities include:

• They’re the two most effective birth control options.
• They both contain progestin and require a healthcare provider to insert and remove it.
• They’re called long-acting reversible contraceptives (LARCs) because they’re effective for years before you need to replace them.
• The implant and an IUD are both “get-it-and-forget-it” birth control, making them highly convenient.

When should I take a pregnancy test after my implant is removed?

It’s possible to get pregnant as soon as your provider removes your implant. This means you may ovulate within a few days. If you’ve had intercourse in the week prior to implant removal, it’s possible that sperm could still be in your body. This means if ovulation occurs, sperm could fertilize an egg.

It takes about 14 days for a pregnancy test to detect pregnancy after ovulation. Once your implant is out, you could take a pregnancy test around this time to confirm pregnancy hasn’t occurred. If you don’t want to get pregnant, consider using an alternate form of birth control as soon as your implant is out.

When should I contact my provider?

If you have a birth control implant, you should contact your provider if you have:

• Pain, swelling or redness in your legs.
• Chest pain.
• Shortness of breath.
• Sudden severe headaches.
• Yellowing of your skin or eyes (jaundice).
• Heavy menstrual bleeding.
• Signs of infection at the insertion site.

A note from Cleveland Clinic

A birth control (contraceptive) implant is a highly effective form of birth control that a provider places under your skin. It releases progestin into your bloodstream to prevent pregnancy for up to three years. Some people love the implant because it’s low-maintenance and convenient. However, the implant isn’t for everyone. Discuss the risks and benefits of the implant with your provider. Together, you can decide if this is the right birth control method for you.