The contraceptive implant Nexplanon is a small soft flexible rod made out of ethylene vinylacetate copolymer (plastic) which contains etonogestrel, a type of progestogen hormone.
How Nexplanon works
The contraceptive implant is a small flexible plastic rod that’s placed under the skin in your upper arm by a doctor or nurse. It releases the hormone progestogen gradually into your bloodstream which prevents pregnancy in three ways – stopping ovulation, making the fluid in your cervix thicker (which makes it more difficult for sperm to enter the womb), and preventing the lining of your womb thickening enough for fertilised egg to implant in it.
Your doctor or nurse will do some tests to make sure that you can have the implant. They check your medical history, make sure that you’re not pregnant and take your blood pressure.
You can have the implant fitted at any time in your period cycle. If it’s fitted within the first five days of your cycle, you will be protected from pregnancy straight away. Any other time in your cycle and you’ll need to use condoms or other contraception for seven days.
You can have the implant fitted straight after giving birth, or after having an abortion or miscarriage.
It won’t hurt to it it. Your doctor or nurse will get you to lie down and inject you with a local anaesthetic to numb the part of your upper arm where the implant will be inserted. They use an applicator like pencil to put it in your arm – it only takes a few minutes to insert and feels similar to having an injection. You won’t need any stitches.
The doctor or nurse will then check your arm to make sure that the implant is in place. You’ll be shown how to feel the implant with your fingers so you can check this too.
They will put a dressing on it to keep it clean and dry – keep this on for a few days and try not to knock your arm. The area may be tender for a day or two and may be bruised and slightly swollen.
We recommend wearing a loose top and don’t expect to have an arm session at the gym the day after getting it fitted.
How to stop using the implant
For contraceptive implant removal, you will need to go back to your doctor or nurse – the procedure is fairly simple and only takes a few minutes. As soon as it’s removed you won’t be protected from pregnancy.
They will inject you with a local anesthetic, then make a tiny cut in your skin and gently pull the implant out. They will put a dressing on the arm to keep it clean and dry and to help reduce any bruising.
Check out our survey results to see how long it took most women’s cycles to return to their definition of ‘normal’ after having their Nexplanon implant removed, and read about other after-effects they’ve experienced.
Things that can go wrong with Nexplanon
You should go back to your doctor if you can’t feel the implant, it feels like it’s changed shape; it becomes painful; or if you get pregnant. Occasionally your arm can get infected straight after the implant is fitted. If this happens you may need to take antibiotics, or get the implant removed.
Some medicines and antibiotics (like rifampicin and rifabutin, St John’s wort and anti-epilepsy drugs) can make the implant less effective. Always tell your doctor or pharmacist that you’re using the implant if you’re prescribed any medication. You’ll need to use condoms or additional contraception until you’re protected from pregnancy again.
Occasionally, the implant is difficult to feel under the skin and it may not be so easy to remove. If this happens, you may be referred to a specialist centre to have it removed with the help of an ultrasound scan.
With any combined type of hormonal contraception there is a slightly increased risk of developing blood clots in your veins and arteries. We are developing a full guide to the medical research on the serious and potentially life threatening side effects of contraceptives here.