Nexplanon: single-rod contraceptive implant


Nexplanon is a single-rod contraceptive implant that is placed in the shoulder and provides protection against pregnancy for up to five years. Nexplanon is about the size of a matchstick and is 1.6 inches long, and is an effective, long-acting, covert contraceptive that contains only progestin .

How does it work

Nexplanon prevents pregnancy by continuously releasing low doses of progestin over a period of three years. The amount of progestin released slowly decreases over time. At the end of the third year, the released dose is too low to prevent pregnancy, so the implant must be removed at this time.


This contraceptive implant is inserted under the skin of your shoulder by a qualified healthcare professional. Before implantation, you will be given a local anesthetic to numb the affected area. Your healthcare professional will use a special applicator to guide the Nexplanon under the skin of your hand.

The installation process takes only a few minutes. After Nexplanon implantation, you will need to wear a pressure bandage for 24 hours and then a smaller bandage for three to five days.

The most common side effects of implantation are short-term pain and swelling. Call your doctor if you develop signs of infection , such as a high fever, bleeding, increased pain, or discharge from the implantation site.

Improvements over Implanon

Nexplanon differs from its predecessor Implanon in many ways. First, Nexplanon is radiopaque, which means it can be seen on X-rays , computed tomography (CT) , ultrasound, or magnetic resonance imaging (MRI) .

This is important because in the past, healthcare professionals had to rely only on touch to confirm the correct implantation position. As a result, many rods were implanted too deeply, which was not only less effective, but could also damage blood vessels and nerves.

With Nexplanon, healthcare professionals can use X-rays or ultrasound to confirm that the bar is in place and easily locate it when it is time to retrieve it.

Nexplanon also has an improved applicator. The new preloaded device can be operated with one hand, making it easy for the healthcare professional to accurately implant the nail without assistance.


Nexplanon is 99.9% efficient when installed correctly. With normal use, 1 in 100 women who take Nexplanon during the year will become pregnant.

Nexplanon may be less effective if you are overweight . This is due to the fact that the amount of hormone actively circulating in the blood will be less in women with a high body mass index (BMI) compared to women with a normal BMI.

To this end, some healthcare providers recommend replacement between the second and third years in women with higher body weight, rather than waiting until the end of the third year.


There are many health and lifestyle benefits to consider when deciding to use Nexplanon. These include :

  • Discreet and confidential
  • Does not require maintenance or daily dosing
  • Safe for those who cannot use estrogen-based contraceptives
  • It works immediately if it is administered between the first and fifth day of menstruation.
  • Safe for nursing mothers four weeks after implantation.
  • It comes with less hormonal ups and downs than other hormonal contraceptives due to the stable delivery of hormones.

Also, Nexplanon might be a good option for you if you don't want to get pregnant now, but want flexibility in family planning after you stop using birth control.

Unlike some forms of hormonal contraception, fertility recovers quickly after stopping Nexplanon, often within 14 days. By comparison, it can take up to a year for fertility to return after stopping Depo-Provera , another long-term birth control method.

Get Medical Information / Cindy Chang

Side effects

The most common side effect of Nexplanon is irregular menstrual bleeding, which includes changes in the frequency, intensity, or duration of bleeding. About 1 in 5 people will not have their period at all while using Nexplanon. Another 1 in 5 people will have frequent and / or prolonged bleeding.

The bleeding pattern that you experience during the first three months after Nexplanon implantation is usually a good indicator of what to expect in the next few months.

Other common side effects of Nexplanon include :

  • Headache
  • Vaginitis
  • Weight gain
  • Acne
  • Chest pain
  • Abdominal pain
  • Throat pain

Other less common side effects have also been reported, including increased appetite, mood swings, decreased sex drive, dizziness, nausea, hot flashes, hair loss, fatigue, and high blood pressure .


Serious problems with Nexplanon are rare, but occur more frequently when the rod is installed incorrectly.

If Nexplanon is inserted too deeply, nerve or vascular damage may occur. This can lead to blood clots (bruising) or abnormal stimulation of peripheral nerve cells ( paresthesias ). Both can become serious if left untreated .

Call your doctor if you notice signs of an implantation injury, including persistent pain, numbness, tingling, confusion, vomiting, lethargy, unsightly scarring, or bruising.

Removal complications can also occur if the rod is installed incorrectly. In some cases, the nail can be dislodged from its original position and requires costly surgical removal.

Incorrect rod placement can also interfere with proper progestin release. This not only increases the risk of pregnancy, but also increases the likelihood of an ectopic (tubal) pregnancy.


Nexplanon is a safe contraceptive option for most healthy people, but not all. Nexplanon is not recommended if you are pregnant or think you are pregnant, or if you have one of the following conditions :

Nexplanon may also not be suitable if you have diabetes, high cholesterol, headaches, epilepsy, gallbladder disease, kidney disease, high blood pressure, or allergies to anesthetics. Talk to your doctor to learn about your personal risks.


Nexplanon prices vary from region to region, but typically range from $ 800 to $ 1,000. The cost of implantation and removal can range from $ 300 to $ 600 per procedure.

While Nexplanon has a higher upfront cost compared to other contraceptive methods , it can save you money in the long run compared to paying monthly for birth control.

Medicaid and many private health plans will cover the cost of Nexplanon, which must be provided free of charge under plans covered by the Affordable Care Act. Possible implantation and extraction surcharge. To avoid surprises, always check with your insurer what your total cash costs will be.

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