What’s a contraceptive implant?

A contraceptive implant is a type of hormonal birth control. In the United States, it’s sold under the brand name Nexplanon. It was previously available under the name Implanon. It releases progestin hormone into the body to prevent pregnancy.

The implant itself is a very small plastic rod about the size of a matchstick. A doctor inserts it into the upper arm, right under the skin. According to the Centers for Disease Control and Prevention (CDC), the typical use failure rate is 0.05 percent. The Guttmacher Institute reports that almost half a million women use the contraceptive implant.

The implant slowly releases a progestin hormone called etonogestrel into the body. Progestin prevents pregnancy by blocking the release of eggs from the ovaries. It also thickens cervical mucus to prevent sperm from entering the uterus.

If you get the implant during the first five days of your period, it’s immediately effective against pregnancy. If the implant is inserted at any other point, you should use a backup form of birth control for seven days.

Some people experience side effects from the implant, but many people don’t. Irregular menstrual bleeding is the most common side effect. Periods may also become lighter, heavier, or stop altogether. Other side effects can include:

Side effects usually go away after a few months and are rarely serious.

You must see your doctor to get an implant. After conducting a physical exam, they’ll insert the implant under the skin of your upper arm. It can stay in place for up to three years. Implant insertions take just a few minutes. They’re done with local anesthetic, which makes the procedure painless.

After insertion, you’ll be sent home with a small bandage covering the insertion site. You may also be given a pressure bandage that you can remove after 24 hours. Some bruising, scarring, pain, or bleeding at the insertion site may occur after the procedure.

The contraceptive implant will stop working after three years.

Implants must be removed after three years. They can also be removed earlier if you wish. You need to make an appointment with your doctor to have the implant removed.

To remove the implant, your doctor will first numb your arm. Then they’ll make a small incision where the implant is located and take the implant out. At that time, another implant can be inserted. If you choose not to get a new implant, you must use another form of contraception to prevent pregnancy.

One reason the birth control implant is so effective is that it’s easy to use. Advantages include:

  • one of the highest levels of effectiveness of all contraceptives
  • no need to worry about birth control for three years
  • fertility returns as soon as the implant is removed
  • appropriate for women who can’t use birth control that contains estrogen

The contraceptive implant does have several disadvantages, including:

Although rare, the implant sometimes migrates from the initial site of implantation. This can make the implant difficult for the clinician to find and remove.

The contraceptive implant isn’t the only type of reversible birth control that works for an extended time. Other long-term birth control options include the:

All of these methods are highly effective. You don’t need to think about birth control on a daily — or even monthly — basis with any of these options. However, none of these methods protect against STIs.

The biggest difference between these methods is how long they’re effective. The Depo-Provera shot needs to be given every three months. The contraceptive implant works for three years. Hormonal IUDs are effective for three-to-five years, depending on the brand. Copper IUDs can be effective for up to 10 years.

Side effects are similar for all of these methods. Irregular bleeding or changes to your period are the most common side effects for each of them. Copper IUDs may have fewer side effects than other options because they don’t contain hormones.

All four methods require a trip to the doctor for insertion or injection. In the case of the implant and IUDs, a doctor’s visit for removal is also necessary.

ImplantNon-hormonal (copper) IUDHormonal (progestin) IUDDepo-Provera
Also known asNexplanon, ImplanonParaGardMirena, Skylan/a
Effective for up to:3 years10 years3-5 years3 months
Failure rate (per the CDC).05%.8%.2%6%
Notable side effectIrregular bleedingChanges to your periodIrregular bleedingChanges to your period
Requires doctor’s visit for insertion or injectionYesYesYesYes
Requires doctor’s visit for removalYesYesYesNo

According the Planned Parenthood site, the contraceptive implant can cost between $0 and $1300, but it’s often covered for free under health insurance plans.

Removal of the implant can cost up to $300, but that too may be covered for free under health insurance plans. Prices can change unexpectedly, so if you have any questions, it’s best to ask before your visit.