NEXPLANON is a birth control option to prevent pregnancy in the long term. It is an implant that can last up to three years. It is not an Intrauterine Device (IUD). Nexplanon is an arm implant that is placed under the skin of the upper arm on the inner side by a healthcare provider. A thin, flexible, and small contraceptive can be over 99% effective, just like a contraceptive pill.

This contraceptive implant prevents pregnancy when it releases hormones that can thicken cervical mucus and prevent the ovary from releasing eggs.

How does the NEXPLANON implant work?

This birth control implant is tiny, like a matchstick, and is called Nexplanon. The name of the older version of Nexplanon is Implanon. The doctor or a healthcare worker will insert the implant under the skin of the upper arm and releases the hormone progestin, which stops the woman from getting pregnant. 

These hormones are present in the birth control implant, and can prevent pregnancy in 2 ways:

  • Progestin can stop the egg from leaving the ovaries (also known as preventing ovulation), meaning there will be no egg to be fertilized. If the eggs aren’t released at all, a woman cannot get pregnant. The sperms that enter the body will have no egg to fertilize.
  • The hormone can also thicken the mucus in the cervix, which will stop the sperm from getting through to the egg. Again, if the sperm doesn’t meet the egg, there will be no fertilization.

The good thing about implants is that it can last for a good amount of time – as long as five years. However, it isn’t permanent. If a woman decides to remove the implant or have children, then it is easy to remove. 

The fertility period resumes after that, and a woman can get pregnant anytime after. It is important to understand that these implants only prevent pregnancy but do not protect against sexually transmitted diseases. Using a preventive barrier like condoms can prevent the chances of contracting STDs.

How to Prepare for The Procedure

The health care provider evaluates the woman’s overall health before inserting the implant. They will determine the correct timing for insertion based on previous birth control and menstrual cycle. 

A woman may need to take a pregnancy test and be on a non-hormonal backup contraceptive for a week. A backup is not required if the woman previously:

  • Did not use any contraception and had the contraceptive implant put into her body in the first five days of the menstrual cycle, even when they were bleeding.
  • Used a mini-pill and had the implant inserted while she was on the pill.
  • Had used a combination of contraceptives like a vaginal ring, birth control patch, birth control pills. 
  • Also, if she had the implant inserted within seven days of the beginning of the hormone-free period.
  • Took a contraceptive injection and then had the implant added when the next injection was due.
  • Previously used an IUD or another contraceptive and then had the Nexplanon inserted after the removal of an old device (like IUD).

Before the insertion, the woman may need to sign a consent form.


The actual procedure does not take longer than a minute. The patient lies on the back, and the arm is bent at the elbow and positioned near the head. The healthcare professional will try to locate a groove between the triceps and biceps. 

The doctors give an injection on the skin in that area using a local anesthetic. With the help of an applicator, they insert the implant. It is a minor surgical procedure, and the device needs to be just below the skin and not too deep. If it’s too deep, then removal will be difficult.

After the insertion, the healthcare professional will feel the device to ensure that the placement is correct. If the woman cannot feel it, then she must let the healthcare provider know and go on a non-hormonal contraceptive until they can confirm that the implant is in place. If the implant isn’t in your arm, then the contraceptive may fail.

After the insertion, the woman may need to wear a pressure bandage for a full day and a small bandage for the next few (three to five) days. It is normal to see some scarring, bleeding, and bruising at the site of insertion.

The woman gets a User Card post-insertion, which notes the date of insertion and date of removal in the future. The woman needs to make an appointment on or before the date of removal to get a new implant.

Women must contact their healthcare provider as soon as possible if they feel or see:

  • Prolonged and heavy vaginal bleeding.
  • Lumps in the breast.
  • Signs of jaundice, like yellow skin and eyes.
  • Signs of a blood clot in the leg, swelling, and pain in the calf.
  • A symptom of infection at the insertion site.
  • Signs of pregnancy after the implant is inserted.


The process of removal is through a small incision made at the insertion site. This can be done at any time in the three years. The doctor gives a local anesthetic to numb the area and prepare the skin for a small cut. The implant is pushed towards the incision and then pulled out with forceps. The implant may need to be removed earlier if the woman develops:

  • Heart disease
  • Migraines
  • Jaundice
  • Uncontrollable blood pressure
  • Depression

Advantage of Using NEXPLANON

Nexplanon is convenient and effective as it is a one-time use method that needs to be replaced in 3-5 years. 

  • It is 99% effective and long-term protection against pregnancy. It works as well as IUDs and sterilization. There can be no errors in the use, and there are no repercussions like the pill if you forget to take it.
  • The implant is private and convenient. Once it’s inside, you don’t have to think about it and it will work until expiration or removal. This also means that there is no pill to take daily or a ring to put, no trips to the pharmacy for contraception, and you can have sex any time you want. The implant is not visible against the skin, so no one needs to know you are on it, keeping your privacy intact.
  • Nexplanon has only one hormone in it, whereas many hormonal birth control devices and methods use two hormones – estrogen and progestin. Some women with health issues cannot use estrogen. So, they can freely use Nexplanon as it is estrogen-free.
  • These implants can make the menstrual cycle better for women. Nexplanon helps in reducing period cramps and pain. The periods one does get is also quite light, and one-third of the users stop getting the period after one year.
  • Fertility is not affected if you remove this implant. Women can get pregnant again after removing the implant. It is a reversible birth control method. It is very much possible that the woman gets pregnant as soon as the implant is out.

Risks & Side Effects of NEXPLANON

Nexplanon can have side effects, and the most common one is a changing menstrual bleeding pattern. One out of ten women may have to stop using Nexplanon because of this change. 

A woman can experience spotting between menstrual cycles, different time periods in between the cycles. There can be times when there are no regular gaps, shorter or longer cycles, or no bleeding at the time of the period. Women must tell their healthcare provider if they think they are pregnant or if the bleeding goes on long and heavy.

Other side effects of Nexplanon can be:

  • Headache
  • Mood swings
  • Acne 
  • Weight gain
  • Depressed mood
  • Inflammation in the vagina
  • Breast pain
  • Painful period
  • Stomach pain
  • Viral infection or flu-type symptoms
  • Nervousness
  • Nausea
  • Backache
  • Pain at the insertion site
  • Dizziness

Apart from the side effects, Nexplanon also has certain risks mentioned as follows:

  • Blood Clots

This implant can increase the chances of blood clots, especially if the woman is prone to smoking. A blood clot can lead to death through a stroke or a heart attack. Patients can experience deep vein thrombosis (clots in the legs), pulmonary embolism (affects lungs) blindness in eyes, a brain stroke, or a heart attack.

  • Ovarian Cysts

Cysts may develop because of the implant, but it may also go away without surgery. Sometimes doctors may suggest surgery.

  • Breast Cancer

Some types of breast cancers are also sensitive to hormones. Therefore, doctors often advise not to use Nexplanon if you are suffering from cancer or have had it in the past.

  • Ectopic Pregnancy

If a woman is using Nexplanon and becomes pregnant, then there is a high chance that it will be ectopic. Ectopic pregnancy is when it is occurring outside the womb and isn’t viable. Abdominal pain or unexpected vaginal bleeding can be a sign of this. Ectopic pregnancies are a health risk as they can cause infertility, bleeding, and death even. It is a health risk that requires surgery.

  • Removal and Insertion problems

The insertion may fail, and sometimes if the implant is not placed correctly in the arm. This can lead to pregnancy. Immediately after the insertion, you must be able to feel the implant in your arm. If you cannot feel it, then you must inform your doctor or health care provider.

Locating or removing the implant may be difficult if it cannot be found in the arm. In such a situation, doctors perform special surgical procedures to remove it. 

These implants have even been found in the pulmonary artery of the blood vessel in the lung. If the implant isn’t found easily, you may need to get an x-ray to locate it. If it is in the chest area, then surgery is the only option.

Other issues faced by a woman using Nexplanon can be infection or injury to blood vessels or nerves. The breakage of the implant may make removal difficult, and once again, surgery may be required. The development of scar tissue around the implant will make removal difficult. The implant may come out by itself, which can cause pregnancy risk. Formation of keloids around the insertion site, irritation, pain, and bruising around the site are also the risks that can occur. 

Cost & Insurance Coverage for NEXPLANON

After deciding that Nexplanon is the best option for a woman, the doctor and patient need to check with the insurance provider for coverage. It is often covered as a pharmacy benefit or a medical benefit. To understand if it’s under a medical benefit, then perform the following steps.

  • Call the customer care number on the health insurance card.
  • Tell the customer care representative that Nexplanon is birth control that is a physician-administered drug and not a device. Explain that the physician will prescribe and order the Nexplanon and then insert it on an office visit. 
  • Ask the representative if this birth control is covered. If they say “no,” then check if it’s a pharmacy benefit. You may have to call on different numbers to check for the pharmacy benefit.

If the pharmacy covers it in your insurance, then check if the Nexplanon and the insertion procedure is 100% covered or not. Check for removal costs, as well. If it is not fully covered, then you can also look for out-of-pocket expenses as well. 

Try to get a verification sent out to the health care provider for coverage. If that verification is not possible, take the name of the insurance representative you spoke to and let the doctor know about your conversation. Post all these steps, get an appointment for the Nexplanon insertion.

If it is not covered, then check with the insurance representative if a medical exception can be authorized and tell your doctor as well. If a medical exception is also not a possibility and you have to pay for it, then decide if you want to do so. Check with the healthcare provider if there are any payment plans you can use.

Final Thoughts on NEXPLANON

Nexplanon is an effective birth control method that is highly effective in the long term. Get more info on our specialized care and insurance coverage for Nexplanon. There are no issues like keeping with the schedule of taking a pill, where you need to take it daily. It is quite convenient and also does not affect fertility. Soon after removal, women can get pregnant. Road to safer birth control is just one step away with Nexplanon. Find out about the insurance coverage for Nexplanon from our health care providers after consulting with your doctor.