Thinking About Getting a Birth Control Implant? Here's What You Need to Know

birth control implant on pink background

Getty/Design by Cristina Cianci 

Taking a hormonal birth control at the same time every day for years on end can get pretty old. Many of us do it so habitually that we don't even think much about it. But if you have been thinking about it, you have options. In terms of long-lasting and reversible forms of birth control that don't require you to pop a pill everyday, know that an IUD isn't your only option. You also may want to consider a birth control implant. Curious what this entails? So were we. So ahead, we've tapped two gynecologists to explain the ins and outs of getting a birth control implant.

What Is a Birth Control Implant?

A birth control implant is a small, thin, removable medical device that gets inserted under the skin of the upper arm and provides protection against pregnancy for up to three years.

Currently, there is just one birth control implant available within the United States—it’s called Nexplanon. Resembling a small, thin rod, the implant is just 1.6 inches long. 

“Birth control implants, like IUDs, are considered long-acting, reversible contraceptives, or LARCs,” explains Nicole E. Williams, a gynecologist with the Gynecology Institute of Chicago. “LARCs are highly effective because they do not depend on regular adherence of the user taking a daily pill or replacing a patch or vaginal ring.”

How Do Birth Control Implants Work?

Nexplanon works by continuously and slowly releasing a synthetic progestin hormone called etonogestrel, explains gynecologist Dr. Tabatha Barber. “The progestin overrides your body’s natural hormonal cycle, and prevents ovulation. It also makes the cervical mucus thicker, so the sperm has a harder time getting into the uterus.”

Basically, the birth control implant works by preventing the sperm and egg from meeting, and by suppressing ovulation.

The Benefits

  • Birth control implants are more than 99 percent effective at preventing pregnancy.
  • They’re also convenient. Once put in place, a birth control implant provides protection for up to three years, with no daily upkeep required.
  • Birth control implants may reduce menstrual flow.
  • Birth control implants may reduce painful period symptoms and endometriosis-related pain. 

Are There Any Potential Risks or Side Effects?

While both safe and effective, birth control implants come with some risks, side effects and drawbacks. Here are a few of the most common:

  • While highly effective at preventing pregnancy, a birth control implant does not protect against sexually transmitted diseases. 
  • A birth control implant may cause spotting or irregular bleeding. “This could mean anything from a little spotting every month or every other month, to prolonged bleeding episodes lasting weeks or months,” Williams says. “Additionally, this bleeding is unpredictable and does not change the longer you have it, unlike the IUD, where its bleeding pattern improves with time.”
  • Some potential side effects associated with the hormone in a birth control implant include acne, nausea, weight gain, abdominal discomfort, breast tenderness, dizziness, benign ovarian cysts, mood changes, and headaches. 
  • When you stop using a birth control implant, there can be a delay in your return to fertility. “The hypothalamic-pituitary-ovarian (HPO) axis is the hormone system by which your brain tells the ovaries what to do, most importantly when to ovulate,” Barber explains. “The implant disrupts this HPO “conversation," and for many women it doesn’t come back online once the birth control is stopped. Six to nine months is the average quoted in the literature for when her period may return.”
  • There is a chance the implant could move. “If you gain a significant amount of weight, the device could migrate, making it more difficult to remove,” Williams says. 

A small percentage of people may experience itching or redness above the site where the implant is inserted.

How Are Birth Control Implants Inserted?

Physicians say that inserting a birth control implant is fairly quick and easy. “The implant is placed, with a minor procedure, under the skin in the upper arm,” explains Dr. Felice Gersh, a gynecologist and founder and director of the Integrative Medical Group of Irvine. “The skin is injected with a small amount of lidocaine prior to the small incision that is needed for the placement of the implant, which just slides into the area beneath the skin, reducing the amount of pain experienced during the procedure.” Overall, she says the pain is very minimal.

Birth Control Implants vs IUDs

The most obvious difference between an IUD and a birth control implant is the location. While an IUD is inserted into the uterus, a birth control implant is inserted in the upper arm on your non-dominant side. A birth control implant typically can stay in place for up to three years, but an IUD tends to last for somewhere between three and seven years, or sometimes even longer depending on the type. 

Dr. Mary Jacobson, OBGYN and chief medical director at Alpha, points out that birth control implants and IUDs come with different side effects. “Notably, changes in bleeding patterns are more common with the birth control implant than progestin-only IUDs,” she says. “Women who use the copper IUD may experience heavier and more painful periods.”

Here's How a Birth Control Implant Gets Removed

After three years, a birth control implant must be either removed or replaced. The removal is pretty simple, and the process is not all that different from the way that it's inserted. Your physician will start by numbing the area and then making an incision over the tip of the implant. “The implant is then guided out through the small slit in the skin and grasped by a small gasping instrument called a mosquito or Kelly clamp,” Gersh says. Next, the implant is removed and the incision can be closed with a Steri-Strip (which is basically a type of surgical tape or bandage that can be used to close shallow wounds and cuts).

The Cost

Like most medical procedures, the cost of a birth control implant will vary depending on whether or not you have insurance. Even with insurance, the cost may vary depending on your specific plan. According to Planned Parenthood, the cost of Nexplanon ranges between $0 and $1300, and removal can range between $0 and $300. But here's the good news: with many health insurance plans, you are not required to pay any out-of-pocket costs for birth control.

The Final Takeaway

Birth control implants are one of the most effective long-term and reversible birth control options available. Insertion and removal are simple and fairly painless, and definitely shouldn't deter you. While birth control implants come with some risks and side effects, for the most part these are safe and likely to appeal to many women, especially those who are looking for a non-estrogen option.

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