A birth control implant is a birth control device that is inserted into your upper arm and releases the hormone progestin to prevent pregnancy. Doctors may not recommend it if you have certain health conditions.
In the United States, the birth control implant is sold under the brand name Nexplanon. It was previously available under the name Implanon.
The implant is a very small plastic rod about the size of a matchstick. A doctor or another healthcare professional inserts it into your upper arm, right under your skin.
Learn what the birth control implant does, how it’s inserted, and what the pros and cons are.
The birth control implant is an effective method of preventing pregnancy.
Pros
- Effective: It’s one of the most effective birth control methods available.
- Long lasting: Once inserted, the implant lasts 3 years before it needs to be replaced.
- Convenient: It doesn’t require any pre-sex prep or reminders.
- Cost effective: It can be a bit costly up front, but after that there are no costs for 3 years.
- Makes periods easier: It can improve cramps and make periods lighter. For some, it may stop periods entirely.
- Reversible: You can have it removed at any time, and your fertility will return right away.
- Does not contain estrogen: It’s safe for people who can’t use estrogen-containing birth control.
Cons
- It doesn’t protect against sexually transmitted infections (STIs).
- Insertion requires a visit to a healthcare professional.
- The device must be removed after 3 years.
- Though this is rare, the implant can migrate from the insertion site, making it difficult for a healthcare professional to find and remove it.
The implant slowly releases a progestin hormone called etonogestrel into your body. Progestin helps prevent pregnancy by blocking the release of eggs from your ovaries. It also thickens cervical mucus to prevent sperm from entering your uterus.
If you get the implant during the first 5 days of your period, it’s immediately effective against pregnancy. If the implant is inserted at any other point in your cycle, you should use a backup form of birth control, such as condoms, for 7 days.
Birth control implants do not prevent STIs. They only prevent pregnancy.
Barrier methods such as condoms help protect against STIs. You can always use a barrier in addition to the implant so you’re protected against both pregnancy and STIs.
You shouldn’t use a birth control implant if you:
- are pregnant or think you might be
- have a history of serious blood clots, such as blood clots in your legs or lungs
- have had a heart attack or stroke
- have a history of breast cancer or any other progestin-sensitive cancer
- have unexplained vaginal bleeding
- are allergic to any of the ingredients or materials in the implant
- smoke cigarettes
Before using an implant, you should also let a healthcare professional know if you have:
- diabetes
- high blood pressure
- gallbladder or kidney conditions
- liver disease
- a history of depression
- high cholesterol
- migraine
- an allergy to anesthetics or antiseptics
At more than 99% effective, the birth control implant is one of the most effective birth control methods available.
However, the implant isn’t the only type of reversible birth control that works for an extended time.
The following long-term birth control options are also available:
- the copper intrauterine device (IUD), ParaGard
- hormonal (progestin) IUDs such as Mirena, Skyla, Kyleena, and Liletta
- the Depo-Provera shot
All these methods are highly effective. With any of these options, you don’t need to think about birth control on a daily or even monthly basis. However, these methods do not protect against STIs.
The biggest difference between these methods is how long they’re effective:
- The Depo-Provera shot needs to be administered every 3 months.
- The birth control implant works for 3 years.
- Hormonal IUDs, depending on the brand, are effective for 3 to 5 years.
- The copper IUD can be effective for up to 12 years.
Side effects are similar for all these methods. Irregular bleeding and changes to your period are among the most common. The copper IUD may have fewer side effects than other options because it doesn’t contain hormones.
All four methods require a visit to a healthcare professional for insertion or injection. If you have the implant or an IUD, you’ll also need to see a healthcare professional to have the device replaced or removed.
| Implant | Nonhormonal (copper) IUD | Hormonal (progestin) IUD | Depo-Provera | |
|---|---|---|---|---|
| Also known as | Nexplanon, Implanon | ParaGard | Mirena, Skyla | — |
| Effective for up to | 3 years | 12 years | 3 to 7 years | 3 months |
| Failure rate | 0.8 in 100 people | 0.1 to 0.4 in 100 people | 4 in 100 people | |
| Notable side effect | irregular bleeding | menstrual changes | irregular bleeding | menstrual changes |
| Medical appointment required for insertion or injection? | yes | yes | yes | yes |
| Medical appointment required for removal? | yes | yes | yes | no |
You must visit a doctor or another healthcare professional to get a birth control 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 3 years.
An implant insertion takes just a few minutes. The healthcare professional will use a local anesthetic, which can help minimize your pain and discomfort during the procedure.
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. You may have some temporary bruising, scarring, pain, or bleeding at the insertion site after the procedure.
The birth control implant will stop preventing pregnancy after 3 years.
Tips to prepare for your appointment
- If you’re already using a different hormonal birth control method, keep using it until your appointment.
- If you’re not using hormonal birth control, use condoms or avoid having penis-in-vagina sex for at least 3 weeks before the appointment.
- Have a list of medications you take ready to bring to your appointment.
- Eat a balanced meal before your appointment. Do not fast.
How fast a birth control implant starts working depends on where you are in your menstrual cycle when it’s inserted.
If it’s inserted during the first 5 days of your cycle, it starts to work right away.
If it’s inserted on any other day of your cycle, you’ll need to use a backup method of birth control, such as condoms, for the next 7 days.
If you’ve been pregnant before, that will also affect how quickly a birth control implant starts to work. Here’s what to expect in different scenarios:
- If you’ve given birth: You can get the implant inserted at any time after giving birth. If it’s inserted within the first 21 days after delivery, it will start working immediately. If it’s inserted on or after day 21, you’ll need to use a backup method of birth control for 7 days.
- If you’ve had a miscarriage: You can get a birth control implant anytime after a miscarriage, and you’ll be protected right away from having another pregnancy.
- If you’ve had an abortion: You can get the implant inserted anytime after an abortion, and protection will start immediately.
Some people experience side effects from the implant, but many people don’t. Irregular menstrual bleeding is the most common side effect. Your periods may also become lighter or heavier, or they may stop altogether.
Other possible side effects include:
- headache
- breast pain
- nausea
- weight gain
- ovarian cysts
- a skin infection where the implant was inserted
Side effects usually go away after a few months and are rarely serious.
What are the risks of using a birth control implant?
Serious complications with the birth control implant are rare but may include:
- improper insertion, which can result in the implant moving into a blood vessel
- injury to nerves or blood vessels if the implant breaks
- increased risk of serious blood clots
A birth control implant must be removed after 3 years. You can have it removed sooner if you wish. You need to make an appointment with a healthcare professional to have the implant removed.
How is a birth control implant removed?
To remove the implant, a healthcare professional first numbs your arm. Then they usually make a small incision where the implant is located and take the implant out. At that time, they can insert another implant. If you choose not to get a new implant, you must use another form of birth control to prevent pregnancy.
Can you get a new birth control implant immediately after removal?
Yes, you can get a new implant right after having the old one removed. Just let a healthcare professional know when you make your appointment.
How much you’ll pay for a birth control implant depends on whether you have health insurance.
The Affordable Care Act (ACA) requires that birth control be covered without a copayment or coinsurance, regardless of your plan type and whether you’ve met your annual deductible. But other services, such as administration and fees for the insertion or removal of an implant, are not specified in the ACA.
According to Planned Parenthood, the birth control implant can cost up to $2,200, but it’s often fully covered by health insurance plans.
Removal of the implant can cost up to $300, but that, too, may be fully covered by health insurance plans. Prices can change unexpectedly, so it’s best to ask before your visit if you have any questions.
Most people who have Medicare or Medicaid don’t pay anything at all for the implant. Those who do have to pay an out-of-pocket share may pay up to $1,092.48, which is the current list price for the device.
If you don’t have insurance, the ACA Marketplace offers private insurance plans for people who don’t have coverage through their employer. Birth control is covered by the plans sold on the marketplace.
If you don’t have insurance and don’t qualify for Medicaid, you may still be able to get the implant at a lower cost or even for free.
Many family planning clinics and health centers have programs that can help you pay for the implant. Options may include:
- Planned Parenthood clinics
- community health centers, such as your local health department
- college and university health centers
- LGBTQIA+ centers
Check out our comprehensive guide to free and lower cost birth control access in all 50 states and Washington, D.C.
How do you get the birth control implant?A birth control implant must be inserted by a trained healthcare professional. You can ask a primary care doctor, a gynecologist, or another healthcare professional about making an appointment.
The healthcare professional will want to know about your medical history and may perform a physical exam to make sure an implant is the best method for you. You may be able to get the implant during the same appointment.
Although many people who get an implant don’t experience any complications, it’s a good idea to know what symptoms could signal a problem.
Contact a healthcare professional right away if you have the birth control implant and you:
- think you might be pregnant
- develop pain in your lower leg that doesn’t go away
- begin to feel sad or depressed
- experience heavy menstrual bleeding
- can’t feel the implant
- can feel that the implant has bent or broken in your arm
- feel a lump in your breast
- notice yellowing of your skin or the whites of your eyes
- develop a fever
Go to the nearest emergency department if you have any of the following symptoms, which could indicate a serious complication or allergic reaction:
- severe chest pain or heaviness
- sudden shortness of breath
- coughing up blood
- a swollen face, tongue, or throat
- trouble breathing or swallowing
- a sudden, severe headache that’s not like your usual headaches
- weakness or numbness in your arm or leg
- trouble speaking
- severe abdominal pain
Adrienne Santos-Longhurst is a Canada-based freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddleboard.