What Is the Birth Control Implant in the Arm Called?
The birth control implant in the arm is called Nexplanon. It is a small, flexible rod about the size of a matchstick that a healthcare provider places under the skin of the inner upper arm. Nexplanon releases a progestin hormone called etonogestrel into the body, which prevents pregnancy primarily by stopping ovulation. It is one of the most effective forms of reversible contraception available, with a typical-use failure rate of less than 1 percent.
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How the Arm Implant Works
Nexplanon works through a combination of mechanisms. The primary action is the suppression of ovulation, meaning the ovaries do not release an egg. The hormone also thickens cervical mucus, making it difficult for sperm to reach the uterus, and it alters the lining of the uterus so that implantation of a fertilized egg is less likely. Because it operates on multiple levels, the implant remains highly effective even if a person occasionally forgets a pill or is late with a shot.
What to Expect During Insertion and Removal
Insertion is a minor procedure performed in a clinic. A provider numbs the area on the inner arm, then uses a special applicator to place the rod just beneath the skin. The process takes only a few minutes and may cause brief pinching or pressure. After insertion, a small bandage is applied, and the arm may be sore for a day or two. Removal is similarly quick. The provider numbs the arm, makes a tiny incision, and gently pulls the rod out. A new implant can be inserted at the same time if desired.
Timeline and Effectiveness
Nexplanon is approved for up to three years of continuous use, though some evidence supports effectiveness for up to five years. It begins working immediately if inserted within the first five days of a menstrual period; otherwise, backup contraception is recommended for the first seven days. Fertility typically returns quickly after removal, often within weeks.
Common Side Effects
Because Nexplanon contains only progestin, side effects differ from those of combined hormonal methods. The most common change is irregular bleeding patterns. Some people experience unpredictable spotting between periods, while others have longer, heavier bleeds or, conversely, much lighter periods or no bleeding at all. Other possible side effects include headaches, breast tenderness, mood changes, acne, and weight gain. These effects vary widely from person to person, and many find them manageable or temporary.
Less Common Risks
In rare cases, the implant can shift from its original position, or a user may develop a small infection at the insertion site. There is also a very small risk of a blood clot, though this risk is lower than with estrogen-containing contraceptives. Anyone with a history of blood clots, liver disease, or certain cancers should discuss these risks with a provider before choosing Nexplanon.
Who Is a Good Candidate
The arm implant is a suitable option for many people, including those who cannot use estrogen-containing contraception due to health reasons such as a history of blood clots or migraine with aura. It is also a practical choice for people who want long-acting, low-maintenance birth control without a daily pill or monthly shot. Breastfeeding individuals can generally use Nexplanon safely, as the small amount of hormone that enters breast milk has not been shown to harm the infant.
Who Should Avoid It
People who should avoid Nexplanon include those with a current or past history of breast cancer, active liver disease, or unexplained vaginal bleeding that has not been evaluated. It is also not recommended for those who are already pregnant. A thorough medical history and discussion with a provider help ensure the implant is a safe choice.
Comparing the Arm Implant to Other Methods
When weighing contraceptive options, the implant stands out for its high effectiveness and convenience. Unlike pills, patches, or rings, it does not require daily or weekly attention. Compared to the hormonal IUD, which also uses progestin, the implant does not involve a uterine procedure, but it can cause more irregular bleeding. The copper IUD, which is hormone-free, may be preferable for those who want to avoid hormones altogether. Each method has trade-offs, and the best choice depends on individual health, lifestyle, and preferences.
Access and Cost Considerations
Nexplanon is covered by most insurance plans, including Medicaid, and many clinic programs offer it at low or no cost. Without insurance, the device and insertion can cost several hundred dollars, though patient assistance programs and Title X clinics can reduce the expense. Anyone interested should speak with a healthcare provider or visit a family planning clinic to discuss whether the birth control implant is the right fit.