The Birth Control Implant

What Is the Birth Control Implant?

The birth control implant, which is sold as Implanon® and Nexplanon®, is a form of hormonal birth control that is inserted subdermally (under the skin) in a female’s upper arm. The device is made up of a flexible piece of plastic about the size of a matchstick. This mode of contraception is unique because it does not require the female to take a pill everyday, or remember to check a string every month; once the rod is placed, no further action must be taken by the user to prevent pregnancy.² The insertion of the birth control implant can be performed in a few minutes during a routine doctor’s visit without any major surgery. The birth control implant contains progestin, which makes it a viable choice for females who can not tolerate estrogen. It will be effective for up to three years, and can be removed at any time.¹ The implant was released in the United States in 2007, and has been available in Europe and Australia since 1998.


How Is It Inserted?

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Before having the birth control implant inserted, it is important to inform your doctor of any previous hormonal contraceptive use and of any abortions or miscarriages you might have had.  Furthermore, your doctor might perform a physical examination and/or give you a pregnancy test. This information will help your doctor time the insertion of the birth control implant so that it starts working immediately. If it is not implanted at the proper time in the female’s menstrual cycle, it will be necessary to use backup contraception for 7 days after insertion to prevent pregnancy.

The birth control implant is surgically implanted by a medical professional just under the skin on the inside of the upper arm. Although it can be placed in either arm, it is generally implanted into the non-dominant arm (e.g. If you are right-handed, it would be placed into your left arm) so that any resulting tenderness in the few days following the procedure does not affect your daily activities. The insertion site is numbed with an anesthetic to help overcome any pain and the  insertion process may take less than a minute which is often described as a slight tugging sensation. It is extremely important to have the Implanon inserted by a trained medical professional in order to avoid any problems and to ensure that the device works properly.

For up to two weeks after insertion, it is possible to have bruising or soreness around the birth control implant. This is completely normal, and is not a cause for concern. If pain persists for a longer period of time or is very severe, contact your medical care provider.  There is also the possibility of scarring at the site of insertion. Most often, the scare is only a small dot or dash that is barely noticeable.

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How Does It Work?

The birth control implant works in two ways. The implant releases a hormone called progestin, which is the same hormone used in the progestin-only pill. Progestin helps prevent pregnancy by inhibiting ovulation, which is the release of a female’s egg from the ovaries. Pregnancy cannot happen if there is no egg to join with the sperm. The implant also makes a woman’s cervical mucus thicker, thereby blocking sperm from traveling into the uterus and fallopian tubes. While the birth control implant is  99.95% effective at preventing unwanted pregnancies, it provides no protection against sexually transmitted infections(STIs). It is advisable to use the birth control implant alongside a barrier method that provides protection against STI transmission.


How Effective Is It?

In clinical trials, the birth control implant has been shown to be 99.95% effective in preventing pregnancy (even more effective than the pill) with less than 1 out of 100 women becoming pregnant while using the implant.¹ There is no difference between perfect and typical user rates, because it is nearly impossible to misuse the implant.

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While most people believe that barrier methods, such as male and female condoms, are the most effective forms of contraception, the most effective forms of contraception include the birth control implant, intrauterine device (IUD), and sterilization. In addition to being more effective than barrier methods, the implant also provides many benefits such as convenience, reversibility, and cost efficiency.

How Is the Birth Control Implant Removed?

The birth control implant can be removed at any time after insertion. However, it is recommended to remove it once three years have passed because it will no longer release hormones after this time. The removal procedure is also relatively pain free and only takes a few minutes longer than insertion. Again, it must be performed by a healthcare professional. The  procedure is simple, and the health care provider numbs the area with a painkiller and makes one small incision to remove the implant. During the procedure, there is the option of inserting a new implant to continue protecting the female against pregnancy for another three years. If a person decides not to reinsert a new implant, then pregnancy can occur anytime after the implant is removed.²

How Much Does It Cost?

Depending on your insurance, the insertion of the birth control implant can cost anywhere from $0 to $800.  The removal can cost between $0 and $300.  Although this is a high cost upfront, the implant is very cost effective since it prevents pregnancy for up to three years. Furthermore,  many insurance plans cover it partially or completely.  Health centers such as Planned Parenthood pride themselves on providing birth control affordably, sometimes even with no costs. If you live in the United States, you can find your local Planned Parenthood by clicking here


What are the Benefits of the Birth Control Implant?

The implant has several prominent advantages over other forms of contraception. These advantages are listed below:

  • can be removed at any time and does not negatively affect a female’s fertility once it has been removed¹

  • can be used while breastfeeding

  • convenient, and does not require daily or weekly action by the female to ensure effectiveness.

  • most effective form of birth control

  • provides long-lasting birth control without the need for sterilization

  • does not contain estrogen

The implant can be very appealing to people who cannot take estrogen and who want a long lasting and low maintenance form of contraception. The implant’s reversibility is also very appealing to females who would like to become pregnant soon after removal of the implant. While the upfront cost may be daunting, the implant can also be viewed as cost effective because it provides protection against unwanted pregnancies for up to three years.

What Are The Risks and Side Effects?

side effects.jpgThe most common side effect associated with the implant is irregular and unpredictable bleeding (these side effects also occur with the Depo-Provera shot).³ Bleeding irregularities could include more, less, or no bleeding than usual as well as random spotting.  However, most women experience fewer and lighter periods.  In fact, after having the birth control implant for a year, 1 in 3 women may have no periods at all.²

Other side effects associated with Implanon are the same as those associated with other hormonal forms of birth control. These side effects include the following: mood swings, a change in sex drive, weight gain, nausea, sore breasts, stomach pain, back pain, dizziness, headaches, acne and depression.⁴ Also, in the rare instance that pregnancy occurs while on the Birth Control Implant, there is a slightly higher chance of having an ectopic pregnancy, which is when a fertilized egg implants itself somewhere other than the uterus, such as in a fallopian tube. Ectopic pregnancies can lead to more serious complications.³

Any severe side effects should be reported immediately to your healthcare provider.⁴  Dangerous side effects may include the following: bleeding, pus, or pain at the insertion site, the formation of a lump in the breast, yellowing skin or eyes, prolonged menstrual bleeding, or not being able to locate the Implanon in your arm.

When to Avoid the Birth Control Implant

Usage of the implant can lead to health complications in some specific circumstances. For instance, you should not use the birth control implant if you:

  • Are pregnant or think you may be pregnant.

  • Have a history of blood clots.

  • Have liver disease or liver tumors.

  • Have unexplained vaginal bleeding.

  • Currently have breast cancer or have had it in the past.

  • Are allergic to any substance in the implant.

One should also exercise caution when considering the implant as a form of contraception if you have one of the following:

  • Diabetes

  • High cholesterol

  • A Seizure Disorder

There are many warning signs that may be indicative of a health complication. Warning signs to be aware of include the following:

  • Severe abdominal pain

  • Chest pain

  • Severe headaches

  • Severe leg or arm pain or numbness

  • Vision problems such as blurred vision

Individuals should ask their health provider if the birth control implant is appropriate for them. Once the implant has been put in place, the patient should pay close attention to their health in order to detect any concerning symptoms as early as possible. If one experiences any of the symptoms listed above, they should contact a healthcare provider immediately.⁴


The birth control implant offers many benefits and is extremely effective at preventing  pregnancy. However, it does not provide any protection against STI transmission, so it is recommended that the implant be used in conjunction with barrier methods such as male or female condoms. Insertion of the implant is a simple procedure that takes only a few minutes and provides over 3 years of contraception. The implant is one of the most effective forms of contraception and offers numerous benefits.

For more on the birth control implant, watch the video below!


  1. “Birth Control Implants: Are They Right For Me?” WebMD. Ed. Traci C. Johnson. WebMD, 25 Aug. 2015. Web. 08 Nov. 2016.

  2. Parenthood, Planned. “Birth Control Implant.” Implanon Side Effects – Birth Control Implant. Planned Parenthood, 03 Aug. 2016. Web. 08 Nov. 2016.

  3. Merck & Co. “How Nexplanon Works.” Nexplanon. Merck Sharp & Dohme B.V, n.d. Web. 08 Nov. 2016.

  4. “Implant.” Cedar River Clinics, 2016. Web. 12 Nov. 2016.

Last Updated: 12 November 2016.