Getting Started with the Sub-Dermal Implant (“Nexplanon”)

What you need to know about using the sub-dermal implant as birth control or for hormonal therapy

How does the implant work?

  • The implant is a small device (the size of a toothpick) that is placed securely under the skin.
  • It releases a small amount of the hormone called progestin.
  • The progestin prevents ovulation (an egg from being released) and keeps the lining of the uterus very thin, making it an effective form of birth control as well as hormone therapy option for problem periods.
  • The implant works for three years. After three years, it should be removed and you can have a new one placed if desired. The implant can be removed sooner if needed.

How do I get the implant?

  • You need to see a trained healthcare provider for insertion and removal of the implant.
  • The insertion is quick. The inner, upper arm is marked with a pen, and then a small amount of numbing medicine is injected under the skin and the implant is inserted.
  • Once inserted, you will be able to feel the implant under the skin.
  • Following the insertion of the implant, the doctor will wrap a bandage around your upper arm, and, under that, a small adhesive bandage over the incision where the implant was inserted.
    • Remove the bandage wrap that night or the next morning.
    • Keep the incision covered for at least two days. You can put a Band-Aid over the incision if needed to keep it clean and protected until fully healed.
    • It is OK to wash and perform all of you normal activities the day after the implant is inserted.

What are the side effects/benefits?

  • You may have no bleeding, spotting (light bleeding) or frequent bleeding following the insertion of an implant.
  • The implant is FDA approved as a contraceptive device, but health providers also recommend it to treat painful and heavy periods because it can help with these conditions.   You might have some minor soreness or bruising on the arm where the implant was inserted. This will go away and is no cause for concern.
  • You can do all of your normal activities after the implant is inserted. It is safe to play sports, do push-ups, lift weights, or whatever is normal activity for you.
  • There is a very small risk of developing an infection in the skin where the implant was inserted. If the area gets red, swollen or tender, please call our clinic.

Please notify your provider if you have ever developed a keloid (very thick scar), as we want to talk about this before the implant is inserted.                                                                        

What if I have a lot of bleeding when I use the implant?

  • If the bleeding is bothersome, keep track of the days you are bleeding and the amount (light, medium, heavy) each day. Collect this information for two to four weeks and discuss it with your provider.
  • You can choose to do nothing, or talk to your doctor about trying ibuprofen (if safe for you to use). Your doctor may also prescribe doxycycline or one to three months of birth control pills.

If I’m using the implant for birth control – when is it safe to have sex?

  • Wait five days after the implant is inserted to have sex.
  • The implant does not protect against STDs (sexually transmitted diseases). If you are sexually active, get tested for STDs regularly and use condoms every time you have sex to prevent STDs, including HIV.

Learn more about STDs