Birth control implant (Nexplanon)

The birth control implant (Nexplanon implant) is a small elastic and plastic rod that is usually placed under the skin of the upper arm by a healthcare professional. This implant prevents pregnancy by releasing the hormone called progestogen into the bloodstream for 3 years.


The hormone in Nexplanon

The hormone contained in Nexplanon etonogestrel (synthetic form of the hormone progesterone).

How does birth control implant work?

Birth control implants like Nexplanon work by using the hormone progesterone to stop your egg from being released by your ovary. It also changes the lining of your uterus. This stops sperm from reaching your egg and fertilizing it.

birth control implant in arm
Birth control implant in arm of the lady-rumruay/shutterstock

Side effects of birth control implant

  • Change in normal pattern of menstrual bleeding
  • Depressed mood
  • Mood swings
  • Headaches
  • Acne
  • Weight gain

Other side effects of Nexplanon include:

  • Vaginitis (inflammation of the vagina)
  • nervousness
  • Breast pain
  • Nausea
  • Dizziness
  • Viral infections such as sore throats or flu-like symptoms
  • Stomach pain
  • Painful periods
  • Back pain
  • Pain

Nexplanon period changes

Period changes due to Nexplanon e.g. bleeding, spotting/bleeding everyday and no period at all. Change in normal pattern of menstrual bleeding is the most common side effect of Nexplanon. Studies have reported about 10% of women stopped using birth control implant because of this because of this change. This change in menstrual bleeding patterns (menstrual periods) include having periods that are longer or shorter than normal, no bleeding at all, irregular bleeding and spotting between periods. You should let your doctor know if you may be pregnant or if you experience menstrual period which is prolonged and heavy.

Nexplanon and weight gain

Women using birth control implants such as Nexplanon have reported weight gain but the link between the birth control implant and weight gain is not strong. According to research only an average body weight of 2.3% is gained and it is not certain that the weight gain was only due to using the implant.

Nexplanon and acne

A study with of 942 women using an implant which contains etonogestrel for an average of two years found that 12% had acne. However only 1.3 % discontinued the use of the implant because of this side effect.

Who should not use birth control implant (Nexplanon)?

You should not use birth control implant (Nexplanon) if:

  • you may be pregnant.
  • have liver disease
  • have arterial disease
  • have a history of stroke
  • have breast cancer now or in the past or have family history of breast cancer
  • can’t tolerate changes to your period.
  • take medication that interact with Nexplanon
  • get unexplained bleeding between periods or after sex

Birth control (Nexplanon) insertion

Insertion of birth control implant takes less that 15 minutes.

  • Sterilize the areas of the upper arm where it is going to be inserted. This is usually the non-dominant arm.
  • Apply local anaesthetic to numb the area
  • Check the anaesthetic is working
  • Insertion of implant using the insertion device. This inserts the rod into the arm.
  • You may asked to feel the rod in your arm
how is nexplanon inserted
how is nexplanon inserted-Akkalak Aiempradit/Shutterstock

Birth control implant removal

Removing Nexplanon implant takes less than 15 minutes

  • Feel where the implant is
  • Sterilize the areas of the upper arm where the implant is.
  • Apply local anaesthetic to numb the area
  • Check the anaesthetic is working.
  • Use a scalpel to create a small incision near the area it was felt or from insertion.
  • Use tweezers to pull out the implant.

Note that while there is a device designed specifically for insertion of the implant, no device to remove it. The picture below shows how Nexplanon is removed.

how nexplanon is removed
How nexplanon is removed-Akkalak Aiempradit/Shutterstock

Nexplanon removal side effects

You may experience the following after the removal of a birth control implant.

  • Bruising
  • Tenderness
  • Pain on site of removal.

Nexplanon Review

Click the highlighted part to read about read more about Nexplanon review

Nexplanon and pregnancy

You should let your doctor know if you may be pregnant.

Nexplanon effectiveness

Nexplanon is an effective method of contraceptive. Less than 1 woman in 100 who use Nexplanon will get pregnant per year.

Can Nexplanon stop working early?

According to the data sheet for Nexplanon (section 4.4) there is no clinical data for efficacy in the third year in heavier women. Health care practitioners (HCPs) should consider replacing birth control implants earlier in women with a high body mass index (BMI).

Pros and cons of birth control implant


  • You don’t have to remember to do anything everyday
  • It is as effective as the pill
  • It lasts for three years
  • It is reversible and your fertility returns to normal as soon as the implant is removed.
  • it does not interrupt sex.
  • It is a contraceptive option for those cannot use oestrogen-based contraception.
  • It a safe method of contraceptive to use while breastfeeding.


  • The major cons are the side effects listed above.
  • It involves a small procedure to both fit it in or remove it.
  • It doesn’t offer protection against sexually transmitted infections (STIs).

Can the birth control implant lasts for 5 years?

A recent study shows that birth control implant protected against pregnancy  for up to 5 years. However most Nexplanon is only licensed for up to 3 years.

Where to get birth control implant

Visit our page on birth control to find out where to get birth control implant.

Birth control implant cost (Nexplanon cost)

You can get Nexplanon for free in most family planning clinics.

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