The Birth Control Implant Nexplanon Really Works, So Here Are 9 Questions You Might Have About It, Answered

We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. No gender, sexual orientation, or question is off limits, and all questions remain anonymous. This week’s topic: the birth control implant Nexplanon.

Q: I suck at taking my pill every day. I’ve actually forgotten all about it a few times and had to take Plan B. Now I’m thinking the pill probably isn’t the best choice for me. I wanna get something I don’t have to think about for a while. A friend told me about birth control you implant into your arm and it protects you for years, is that for real? It seems like some sci fi experiment to me. Can people, like, SEE it wherever they put it? And is it actually safe?

A: If you’re someone who wants to protect themselves against pregnancy but has a hard time remembering to take a pill every day, you’re in great company. In fact, research has found that around 30 percent of people on the birth control pill miss at least one dose each month. Luckily, the pill isn’t your only option. Allow me to introduce ... long-acting reversible contraception, or LARC for short. LARC is the term used to describe both intrauterine devices (IUDs), and implants. Let’s break down that name, shall we?

Long-acting: Once you put a LARC in, you don’t have to think about it for at least three years (the implant) or even up to ten years (the copper IUD)! Reversible: Once you take out a LARC, you go back to being fertile. So they are great options if you don’t want to make babies now, but may in the future. Contraception: LARCs stop you from getting pregnant.

Because you don’t have to remember them once they’re in, LARCs are listed by the American College of Obstetricians and Gynecologists as the most effective choice. I’ve written about IUDs already, so today we’re going to learn about implants!

What Is It?

First things first: what is this sci fi nonsense? Can the government track you with it? All great, yet irrelevant questions. The birth control implant is a very tiny rod (the size of a matchstick) made out of flexible plastic that contains hormones. It’s implanted in the skin of the upper arm, and because it’s so tiny you probably won’t be able to see it. Once it's in, you can keep it there for up to three years!

The birth control implant approved for use in the United States is called Nexplanon. This implant is only visible with an x-Ray, which makes it easy for your doctor to make sure it's in the right place.

How Does It Work?

The implant works similarly to other forms of birth control — it slowly and steadily releases the hormone progestin. This chemical is the synthetic version of progesterone, a hormone your body makes naturally. Progestin does a couple of things: It stops your ovaries from releasing mature eggs. It also makes your cervical mucus thicker, so that it acts as a physical barrier preventing sperm from getting up into your uterus at all. Finally, this chemical makes your uterine lining thinner, which not only makes it harder for a fertilized egg to implant and grow into a baby, but also has the perk of making your periods lighter.

How Well Does It Work?

Healthcare providers aren't joking when they say that LARC options are the most effective methods of birth control. The implant is more than 99 percent effective, which means that fewer than one in one hundred people will get pregnant each year if they have an implant. And there's no human error involved — you can't forget to use it, because it's already in your arm, protecting you.

There are a couple things that can make the implant less effective. These include medications for yeast infections, tuberculosis, HIV, seizures, and some mental conditions. Some herbs, like St. John's Wort, can also mess with the implant's effectiveness. Finally, there isn’t enough research yet to be completely sure that the implant is as effective in people with a body mass index (BMI) higher than 30. (Seriously, someone get on that research.)

Finally, it's important to remember that the birth control implant only protects you from getting pregnant. It doesn't act as a barrier against sexually transmitted diseases (STDs). If you're worried about getting an STD, or you have an STD and want to protect your lover(s) from getting it too, pair your implant with a condom. Then you'll be super safe!

How Do I Get It?

In order to get a birth control implant, you'll need to see your doctor. Before you can get actually implanted, your doctor will make sure it's the best method for you — this can mean taking your medical history, getting a list of all the medications you're on (remember that some can diminish the implant’s power), completing a pregnancy test, and giving you a pelvic examination.

Once you're ready to actually get the implant, your doctor will numb the area on your arm that’s between your bicep and tricep muscle (so basically your inner upper arm) with a local anesthetic. Then she’ll insert the implant under your skin. The whole process only takes a couple of minutes. She’ll bandage you up, and then have you feel the implant so you know where it is and what it feels like. She may also give you an x-Ray or ultrasound so you can both see where it is. You may experience some bruising, bleeding, or even a bit of scarring.

How Soon Does It Start Working?

When the implant starts being effective is dependent on where you are in your menstrual cycle. If you get it in the first five days of your cycle (so when you’re on your period) it starts working immediately! If you get it any other time during your cycle, you will need to use another method of contraception for a week, so don’t give all your condoms away.

How Do I Remove It?

You can get your implant taken out at any time, but you definitely need to take it out after three years, because that’s its lifespan. To get it removed, you’ll need to go back to your doctor. She’ll numb your arm with a local anesthetic and make a small cut to get the implant out. You can also get a new implant put in at this time, if you want to keep going with this method of contraception. The whole removal process also only takes around five minutes, generally a bit longer than insertion.

It’s important to remember that the implant is reversible contraception, which means that you can get it removed at any time and get pregnant right away after your implant is removed.

What Are The Benefits?

Many people love their implants! Here are some of the reasons why: You don’t have to remember it — once it’s in, it’s in for three years. That means no trips to the pharmacy, and no daily alarms on your phone for three whole years. And what’s more, it’s invisible. That’s right, no one can see it in your arm, and there’s no pill you’re taking or thing you’re inserting into yourself before sex. That means no one else has to know you have it. 

It also doesn’t interrupt you in the moment, which is a problem some people have with condoms. Finally, the hormones it’s releasing into your body often makes you have lighter periods (one in three people using the implant will have their periods stop altogether after one year) and it can improve PMS symptoms as well as pain from endometriosis.

What About Side Effects?

As with all hormonal birth control options, there are some potential side effects to consider. Some people experience irregular bleeding (which could be spotting or longer/heavier periods) for up to the first year. Less common side effects include acne, weight gain, changes in appetite and sex drive, depression, anxiety, headaches, dizziness, nausea, tender breasts, vaginal dryness, pain in your pelvic/back region, ovarian cysts, and some pain/discoloration where the implant is.

How Much Does It Cost?

Implants can cost between $450 to $800 — if you have to pay for it out of pocket. Luckily, with the Affordable Care Act covering birth control, your insurance should cover the entire cost! And even if you have to pay for it, it’s a single up-front cost and then you don’t have to pay anything for up to three years. Removal can cost anywhere from free (if your insurance covers it) to $300 if you’re paying out of pocket.

The Bottom Line

LARC is on the rise, with healthcare providers telling their patients about it and more and more people realizing that remembering a pill every day is hard and unnecessary. The implant takes the human error out of contraception, allowing you to be fully in control of your fertility. If this sounds good to you, talk to your provider about getting implanted! And then congratulate yourself, because you’re not only taking charge of your family planning, you’re also kinda a badass cyborg. 

Images: Nexplanon, Giphy

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