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Illustration by Maya Chastain

A birth control 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 or other healthcare professional inserts it into the upper arm, right under the skin.

According to the Centers for Disease Control and Prevention (CDC), less than 1 out of every 100 people using the implant became pregnant.

The Guttmacher Institute reports that over 1.4 million people in the United States use a birth control implant.

Pros

  • Effectiveness. It’s one of the most effective birth control methods available.
  • Longevity. Once inserted, the implant lasts 3 years before needing to be replaced.
  • Convenience. No pre-sex prep or reminders.
  • Cost effective. It can be a bit costly upfront, but there are no costs beyond that for 3 years.
  • Better periods. It can improve cramps, make periods lighter, or stop them entirely for some.
  • Reversible. You can remove it at any time and your fertility will return as soon as it’s removed.
  • No estrogen. It’s safe for people who can’t use birth control that contains estrogen.

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 rare, the implant can migrate from the insertion site, making it difficult for a clinician to find and remove.

At over 99 percent effective, the birth control implant is one of the most effective birth control methods available.

The implant slowly releases a progestin hormone called etonogestrel into the body. Progestin helps prevent 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 5 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, such as condoms, for seven days.

Nope, birth control implants don’t prevent STIs — just pregnancy.

Barrier methods like 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.

Yes. 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 cigarrettes

Before using an implant, you should also let a healthcare professional know if you have:

The birth control 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 administered every three months. The birth control implant works for three years. Hormonal IUDs are effective for 3 to 5 years, depending on the brand. Copper IUDs can be effective for up to 12 years.

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

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

ImplantNon-hormonal (copper) IUDHormonal (progestin) IUDDepo-Provera
Also known asNexplanon, ImplanonParaGardMirena, Skylan/a
Effective for up to3 years12 years3–7 years3 months
Failure rate0.1 in 100 people0.8 in 100 people0.1–0.4 in 100 people4 in 100 people
Notable side effectsIrregular bleedingMenstrual changesIrregular bleedingMenstrual changes
Requires clinician appointment for insertion or injection YesYesYesYes
Requires clinician appointment for removalYesYesYesNo

You must see a doctor or other 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.

Implant insertions take just a few minutes. They’re done with a local anesthetic, which can help minimize 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. Some bruising, scarring, pain, or bleeding at the insertion site may occur temporarily after the procedure.

The birth control implant will stop preventing pregnancy after three 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 insertion.
  • 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.

It starts to work right away if it’s inserted during the first 5 days of your cycle.

If it’s inserted on any other day of your cycle, you’ll need to use a backup method of birth control, like condoms, for the next 7 days.

Having been pregnant before also impacts 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 any time after giving birth. If it’s inserted within the first 21 days after delivery, it will start working immediately. If it’s fitted 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 will be protected right away.
  • 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. 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.

What are the risks of using a birth control implant?

Serious complications with the birth control implant are rare, but it’s still important to know about the potential risks.

These include:

  • Improper insertion, which can lead to the implant making its way into a blood vessel.
  • Injury to nerves or blood vessels if the implant breaks.
  • Increased risk of serious blood clots.

Birth control implants must be removed after three years. They can also be removed earlier if you wish. You have 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 clinician 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.

Yes, you can get a new implant right after having the old one removed. Just let a healthcare professional know that’s what you want when you make your appointment.

How much you’ll pay for a birth control implant depends on whether or not you’re insured.

The Affordable Care Act (ACA) requires that birth control is covered without a copayment or coinsurance, regardless of your plan type and whether you’ve met your annual deductible. Other services, however, like administration and fees of the insertion or removal of an implant are not specified in the ACA.

According to the Planned Parenthood site, the birth control implant can cost up to $1,300, 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.

Most people who have Medicare or Medicaid don’t pay anything at all for the implant. Those that do have to pay an out-of-pocket share may pay up to $1,030, 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. For example:

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. Consult with a primary care physician, gynecologist, or another clinician to make an appointment.

Your clinician will want to know about your medical history and possibly 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 signs could signal a problem.

Consult with a healthcare professional right away if 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 or feel that the implant has bent or broken in your arm
  • feel a lump in your breast
  • notice the yellowing of your skin or whites of your eyes
  • fever

Go to the nearest ER 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
  • 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 paddle board.