Nexplanon

Nexplanon

What is it?

Nexplanon is a type of long term contraceptive method. It is a soft, flexible rod that is inserted under the skin of your upper arm. It gradually releases the hormone progestin to prevent pregnancy for up to 3 years. It contains progestin and does not contain estrogen. It is more than 99% effective at preventing pregnancy, so your chance of becoming pregnant is very low with a properly inserted Nexplanon.  

How does it work?

Nexplanon thickens the mucous in the cervix and changes the lining of the uterus.  It often also stops the release of an egg from the ovary.

The procedure to insert Nexplanon is fairly simple and safe. In a medical clinic, the upper arm is cleaned, then numbed with an injection under the skin, and the Nexplanon is inserted just under the skin in the numb area. Bruising is expected but generally the discomfort is minimal and the area heals within 3-5 days.

The procedure to remove Nexplanon is also straightforward. In a medical clinic, the upper arm is cleaned, then numbed with an injection under the skin. A small incision smaller than a dime is made near the Nexplanon tip and the Nexplanon is removed with sterile instruments. Sutures are usually not needed to close the incision, and the area heals within 3-5 days.  

What are the advantages of using Nexplanon?

  • Nexplanon is very convenient
  • It is highly effective in preventing pregnancy
  • It is cost effective over time, though the initial cost is high (but most insurances cover Nexplanon very well)
  • It does not contain estrogen
  • It is easily reversible by removing the Nexplanon implant in a simple outpatient procedure in the office.

What are the disadvantages of using Nexplanon?

The most common side effect of Nexplanon is a change in your normal menstrual bleeding pattern. Some women will notice shorter or longer bleeding. Some women may have bleeding or spotting between periods. Some women will have no bleeding at all. About 1 out of 10 women have Nexplanon removed early due to an unfavorable change in the bleeding pattern.

Other possible side effects include:

  • Mood swings
  • Weight gain
  • Headache
  • Acne
  • Depressed mood

The hormone in Nexplanon theoretically could cause an increased risk of blood clots in the veins and arteries of the body. Blood clots can cause pulmonary embolus, heart attack, or stroke which can be serious and sometimes fatal health issues. However, this theoretical risk of blood clot has not been seen in large studies of Nexplanon users. Due to these studies, the Centers for Disease Control and World Health Organization have approved Nexplanon as safe for people who smoke and have a history of blood clots.  

If you do become pregnant using Nexplanon, there is a slight increased risk of ectopic pregnancy (pregnancy occurring outside of the uterus). You should contact your health care provider for any unusual bleeding or abdominal pain.

There is a slight increase risk of ovarian cysts with use of progestin only methods. These usually go away without treatment but can be painful.

Nexplanon is not recommended for women who are overweight because it is unknown how effective it is in preventing pregnancy for overweight women.

Nexplanon does not protect against sexually transmitted infections including HIV.

What potential issues are associated with insertion and removal of Nexplanon?

If Nexplanon is inserted and removed correctly by a trained provider, the insertion and removal procedures are generally very safe and have minimal complications.  Potential problems related to insertion or removal could include:

  • Pain, irritation, swelling or bruising at the insertion site
  • Scarring, including a rare occurrence of a thick scar called a keloid at the insertion or removal site.
  • Infection
  • Scar tissue may form around the implant making it somewhat difficult to remove
  • Other rare complications include incomplete insertion, incorrect insertion resulting in injury to surrounding nerves or blood vessels, or implant breakage.

The Nexplanon implant should be palpable under the skin. If the implant is not palpable under the skin, your provider may do xrays or other imaging to locate it.

You should not use Nexplanon if:

  • You think you might be pregnant
  • You have abnormal vaginal bleeding without a known reason
  • You have had cancer of the breast or reproductive organs
  • You have had a stroke
  • You have or had blood clots (phlebitis) in your legs
  • You have problems with your liver or liver disease

Talk to your health care provider about the best time to have Nexplanon inserted.

Tell your health care provider about any medications you are taking before having Nexplanon inserted. Some medications may make Nexplanon less effective. It is also important to discuss any health problems you have. You should also inform health care providers that you are using Nexplanon.

You can find out more about Nexplanon by scheduling a consultation with one of our providers.