The Birth Control Method That’s Even More Effective Than An IUD
If you’re not into getting pregnant any time soon, you’ve probably done your fair share of birth control research. In evaluating your options, you’ve likely heard someone—maybe even us—preaching the IUD gospel: With over 99 percent efficacy, intrauterine devices are one of the most solid options for keeping your uterus fetus-free. But Nexplanon, an implant that goes in your arm, is right up there with them—and according to the data, sometimes it even has a slight edge over IUDs.
Here, everything you need to know to decide whether Nexplanon is right for you.
Nexplanon is a little matchstick-sized rod that gets implanted in the upper arm—which might sound weird, but it works.
Commonly called “the implant,” Nexplanon is small yet mighty. All its baby-fighting power comes in the form of a flexible plastic stick that is around an inch and a half long, board-certified ob/gyn Antonio Pizarro, M.D., tells us. It prevents pregnancy for up to three years by steadily releasing the hormone etonogestrel.
A synthetic version of the hormone progesterone, etonogestrel prevents ovulation by basically tricking your body into constantly thinking it’s already released an egg, Jamil Abdur-Rahman, M.D., board-certified ob/gyn and chairman of obstetrics and gynecology at Vista East Medical Center in Waukegan, Illinois, tells us. It also thickens the cervical mucus, which makes it harder for sperm move around.
You may hear people call Nexplanon by the name Implanon, but there’s only one contraceptive implant currently on the market. Implanon is Nexplanon’s predecessor. Nexplanon is the new and improved form, revamped so it’s easier to insert, Pizarro explains.
Just like the IUD, the implant is a great option for someone who wants something long-lasting but more low-maintenance in the day-to-day than the Pill or NuvaRing.
Better yet, Nexplanon’s protection is basically unmatched. While the hormonal IUD’s failure rate is 0.2 percent and the copper IUD’s stands at 0.8 percent, Nexplanon squeaks past both with an even lower failure rate of 0.05 percent, according to the Centers for Disease Control and Prevention.
“It does make things easier for women, and it’s also nice, discreet option if someone is looking for that,” says Abdur-Rahman. It’s often possible to feel the implant through the skin of your arm, but usually you can only see it if your arm is really thin.
Insertion and removal may sound scary, but they’re actually very simple procedures.
Yes, if you want the implant, it has to get inserted under the skin of your arm. “It doesn’t require a large incision—it’s a very small cut, almost more of a puncture,” says Pizarro. Your doctor will numb the area first, so besides the anesthesia injection, you shouldn’t feel much of anything. It definitely shouldn’t be as uncomfortable as IUD insertion is often reported to be. “The implant [insertion] is a little bit of a nuisance, but not a big deal,” says Mary Jane Minkin, M.D., a clinical professor of obstetrics and gynecology at Yale Medical School. “Numbing the cervix is a little bit trickier!”
If you get the insertion during your period, Nexplanon starts working immediately. If not, you’ll need backup contraception for seven days, says Pizarro. And no matter what, your doctor will probably have you wear pressure bandages for a few days, says Nexplanon’s site, but after that you’re golden.
Removal should also be pretty straightforward. “It simply requires another incision, then the implant is pulled out with pressure instrument,” says Pizarro. In rare cases, Nexplanon can get stuck or the doctor may have a hard time locating it, in which cause removal may require surgery. But that’s so rare Pizarro’s never heard of anyone actually having to get it done. “The skin is an interesting organ—the connective tissue has an integrity that keeps things from moving around,” he explains.
Even though it’s a lot like a hormonal IUD, Nexplanon doesn’t always have the same period-improving effects—and it sometimes makes things a little worse.
Both Nexplanon and the IUD Mirena release a progestin hormone, but the latter “dumps that right on the lining of uterus, which is where action is,” says Minkin. On the other hand, she explains, the implant’s hormone is traveling around in the bloodstream before it gets to the uterus. But even that is enough for some people’s periods to get lighter or stop, says Pizarro.
That said, your cycle might get thrown out of whack after you start Nexplanon, and this effect can actually last the entire time you have it. “The implant can give you some funky bleeding,” says Minkin. In addition to irregular periods, you might also develop side effects like breast pain and headaches even if you never experienced them during regular PMS, Pizarro adds.
Once you get Nexplanon removed, you go back to regular fertility pretty much immediately.
Think it’s time for a baby? Cool. All it takes is a few quick minutes for removal, then you’re ready to start trying to conceive, says Minkin.