AWHC Blog: Información&Inspiración

The Implant: Side Effects, Efficacy, and What to Expect

March 29, 2021

When thinking about what birth control to use, keep in mind that with any long-acting reversible contraception device, changes in menstrual cycles and other Nexplanon side effects are possible. Nexplanon users can experience heavy and excessive bleeding, so if you already have a heavy period, there’s a chance the bleeding could increase. Not everyone will experience this, but it’s important to know the possibility beforehand. And as with other LARCs, scheduling a visit to remove the device is always an option should you experience uncomfortable periods or levels of bleeding following insertion. Just contact your provider if you’d like to discuss removal, and keep reading to learn about the benefits and possible Nexplanon side effects.

The Nexplanon (also known as The Implant or Implanon) is a long-acting reversible contraception device (LARC) that’s over 99% effective in preventing pregnancy for up to four years. (It must be removed before the end of the third year). It works by releasing progestin, a hormone that prevents your ovaries from releasing eggs and thickens the cervical mucus to prevent sperm from reaching the egg at all. The Implant is a tiny device that’s inserted into your upper arm, completely discreet and hidden from view — although you may be able to feel it with your hand if applying pressure. The cost can range anywhere from free to hundreds of dollars, so finding out what insurance coverage you have for the insertion and removal ahead of time can be helpful. If you don’t have insurance, see if there’s a Title X clinic near you. Title X clinics provide anyone with low-cost or free contraception, regardless of lack of insurance, how much money you make, how old you are, or your citizenship. 


What Are The Benefits of Nexplanon?


Quick Insertion


Following a negative pregnancy test, your provider will talk to you about the best time to insert the Implant. The Implant is a minor surgical procedure—that only takes a few minutes!—in which an applicator guides the insertion of a very small rod into the skin of your upper arm. Most people don’t experience pain from insertion, and your provider will numb the area beforehand. Afterward, placement will be checked by making sure you can feel the Implant—and if at any time you can’t feel it, you should contact your provider to confirm the placement of your device, and use a back-up method of birth control for additional protection. (Doctors can now detect placement of an Implant using X-rays and other scans). Expect your provider to advise that you apply pressure to the insertion site by using a bandage in the following days.


One and Done


Once it’s in, you’re protected from pregnancy for up to four years! You don’t have to take a pill every day or follow up with your doctor. However, as we mentioned before, you should continue to check the placement of your Nexplanon, as in rare circumstances failed insertions that leave you unprotected have occurred. If you’re concerned about an unexpected pregnancy, it’s also important to schedule a removal procedure before it’s set to expire to ensure you don’t risk being unprotected. 




Since the Implant is inserted into the skin of your upper arm, it’s completely hidden. Even though you can feel it, others won’t know it’s there, and unlike IUDs (which are attached to strings), the Implant can’t be felt by a partner during sex. For people experiencing reproductive coercion — like a partner attempting to force pregnancy on us — a discrete method of birth control that provides protection for years may also be invaluable and allow you control over your own reproductive health. 


You Can Get Pregnant Again Right Away When It’s Removed


LARCs, with the exception of Depo Provera, has not been shown to impact our ability to get pregnant following the removal of the device. Unlike the Depo shot, which can potentially stop our menstrual cycles for up to six months and cause a delay in getting pregnant, once the Nexplanon is removed you’re able to get pregnant almost immediately. So if you’re looking for a method that provides you control over planning your family when you’re ready, consider a LARC like the Implant or IUD.


Possible Nexplanon Side Effects


Changes In Menstrual Cycles


Some people using Nexplanon experience irregular or heavy bleeding, and studies have shown 1 in 10 people stop using the device because of this specific Nexplanon side effect. Your periods may be longer, shorter, or heavier—or you may not have any bleeding at all. It’s also possible to experience spotting between periods and inconsistent lengths of cycles. Talk with your doctor about which LARC may work best for you and what your goals are for managing any menstrual issues you currently experience.


Hormonal changes


As with any hormonal birth control, people have reported other Nexplanon side effects, such as mood swings, depression, weight gain, acne, and more. Keep your provider up to date regarding any sudden or new symptoms you experience following your device insertion. Sometimes these changes may not happen right away, so even if your device was inserted a while ago, you should still let your doctor know. Finding a birth control method that works for you can be trial and error. Some people find their perfect fit with the first method they try, but it’s also normal to try different options before figuring that out. Depending on the side effects you experience, your doctor may also be able to recommend something that may work better.


Who Shouldn’t Use Nexplanon?


Risk Factors


According to the manufacturer’s website, Nexplanon is not suitable for people who:


  • Are pregnant or might be pregnant
  • Have a history of blood clots
  • Have liver disease or a tumor of the liver
  • Are experiencing unexplained vaginal bleeding
  • Have breast cancer
  • Are allergic the ingredients in Nexplanon


You should also tell your provider if you have a history of certain health conditions (like diabetes, headaches or migraines, high blood pressure, and more). While it isn’t known if Nexplanon causes breast cancer, some breast cancers are sensitive to hormones and it shouldn’t be used if you have or have had breast cancer. Nexplanon can also increase the risk of serious blood clots, which is why it isn’t recommended if you have a history of blood clots already. 


When Should I Call My Doctor?


Your provider will review possible signs of complications before the Implant is inserted so you know when to call if needed. The manufacturer also provides a list of signs to watch for and advises patients to contact their provider should any of the following occur while using Nexplanon:


  • Constant pain in your lower leg 
  • Severe/sharp chest pain/heaviness 
  • Sudden shortness of breath
  • Coughing blood
  • A severe allergic reaction, like a swollen face, tongue, or throat, or difficulty breathing or swallowing
  • A severe headache unlike your usual headaches
  • Weakness/numbness affecting the limbs or trouble speaking
  • Vision loss/blindness 
  • Jaundice, especially accompanied by a fever, tiredness, loss of appetite, dark-colored urine, or light-colored bowel movements
  • Extreme pain, swelling, or tenderness in the lower stomach
  • Breast lumps
  • Insomnia, sleep changes, depression, mood changes
  • Excessive menstrual bleeding
  • Felt that the Implant may have broken or bent while in your arm, or that it may be out of place


The risk of ectopic pregnancy is also higher when using Nexplanon, so make sure to contact your doctor if you suspect you may be pregnant while using it. 


Call us at Austin Women’s Health Center to Schedule an Appointment for Nexplanon


Our staff can let you know what insurances we accept and, if applicable, what portion of costs you’ll be responsible for. If you’re visiting our clinic for surgical abortion and are seeking long-term birth control, we may be able to insert a device right after your procedure depending on device availability. Austin Women’s Health Center is dedicated to providing you with quality and compassionate care that is considerate of each patient’s unique needs and situations. Using birth control is a personal decision, in the same way having an abortion is, and we want you to feel informed and supported when making decisions involving your reproductive health. If you are still not sure if Nexplanon is right for you, read our post about finding the best birth control option for you.