A Nexplanon implant is a long-term and effective birth-control method for women. In this method, a match-stick sized implant is inserted underneath the skin in the inner upper side of your non-dominant arm, about 8-10 cm (3-4 inch) above the elbow bone.
The particular location of the implant is very important due to the following reasons:
- Less painful: When it is correctly implanted at the particular part of your arm, it won’t hurt much.
- Less chance of failure: When the placement of the implant is correct, your chances of getting pregnant are very low, which is less than 1 pregnancy per 100 women who use an implant for 1 year. If it is not placed correctly it may fail and you may become pregnant.
- Safety assurance: If the implant is inserted in a particular place, it is very much palpable to you, and it means it is alright. If it is implanted deep, it may require an X-ray or ultrasonography to locate it. Mostly, you can feel the implant just under your skin; however, everyone may not be able to feel it. If you notice one day that you no longer feel your implant when you previously could, do not panic, because there is no way to expel the implant or have it come out of your body. If you have concerns or if you want to be assured, you must see your doctor.
- Protect from moving around: A protective layer of fibrous tissue in your arm naturally holds the implant and stops it from moving around. If the implant is placed deep inside the muscle, there are higher chances that it may move to other organs and cause complications.
- Less risk: To reduce the risk of injury to nerve or blood vessels, the particular site placement is very important. If the implant is not inserted as per the given instructions, then it can lead to deep and impalpable implants. Deep insertion may risk damage to nerve and blood vessels, migration of the implant, and rarely, insertion into a blood vessel.
- Less difficult or complex to remove: If an implant is placed very deep, it will be difficult or sometimes impossible for the clinician to remove it after 3 years. Also, it may require many attempts for removal or may require surgery. It may leave more swelling and scarring or may damage blood vessels and nerves while removing.
What is the Nexplanon implant?
Nexplanon is a small, thin, flexible, and matchstick-sized plastic implant device that is placed underneath the skin of your inner upper arm. If you are right-handed, doctors place it in the left arm and vice versa. It is considered a long-acting birth control option for women, to prevent pregnancy for up to 3 years and must be removed after 3 years.
The implant continuously releases a hormone, progestin (etonogestrel), that stops an egg from being released from your ovary, prevents sperms from reaching the egg, and changes the linings of your womb. It also contains a small amount of barium sulfate for its better visibility under X-ray.
What happens during the implantation?
What happens:
- To avoid infection, proper sterile methods must be used during the insertion of the implant, such as the use of hand hygiene, sterile gloves, and correct skin disinfection.
- A trained doctor or nurse will give local anesthetics, which will numb the part of your arm where the implant will be inserted.
- The doctor may mark the insertion point at 8-10 cm (3-4 inches) above the elbow of your inner side of the upper arm (especially the nondominant arm) and another point around 4 cm above as a direction guide.
- It only takes a few minutes to put in, feels similar to having an injection, and you do not need any stitches.
- After implantation, you may get bruising at the implant site, which is normal.
Who should not use Nexplanon?
You should not use Nexplanon if you have
- Pregnancy
- Doubt that you are pregnant
- Blood clots or tendency to having blood clots
- Liver disease
- Liver tumor
- Unexplained heavy periods
- Breast cancer
- Any other cancer that is sensitive to the progestin hormone
- Allergy to the content of the implant
What are the possible complications?
Complications include:
- Pain, irritation, swelling, or bruising
- Numbness and tingling
- Scarring
- Infection
- Failed insertion
- Failed birth control (pregnancy)
- Difficulty in removing
- Injury to nerves or blood vessels
- Ectopic pregnancy (pregnancy occurring outside the womb)
- Unusual vaginal bleeding or lower belly pain
- Ovarian cysts
- Breast cancer
- The implant moves to other organs, such as the lungs
- Serious blood clots in
- Legs (deep vein thrombosis)
- Lungs (pulmonary embolism)
- Brain (stroke)
- Heart (heart attack)
- Eyes (blindness)
- A broken or bent implant
QUESTION
Which of the following are methods for contraception? See AnswerReferences
WebMD. Nexplanon implant. https://www.webmd.com/drugs/2/drug-156597/nexplanon-subdermal/details
Electronic medicines compendium (emc). Nexplanon 68 mg implant for subdermal use. https://www.medicines.org.uk/emc/product/5720/smpc#gref
FDA approved patient labeling. https://www.merck.com/product/usa/pi_circulars/n/nexplanon/nexplanon_ppi.pdf
Australian Family Physician. Implanon NXT: Expert tips for best-practice insertion and removal. https://www.racgp.org.au/afp/2017/march/implanon-nxt-expert-tips-for-best-practice-insertion-and-removal/
NHS. Contraceptive implant. https://www.nhs.uk/conditions/contraception/contraceptive-implant/
Planned Parenthood. Birth Control Implant. https://www.plannedparenthood.org/learn/birth-control/birth-control-implant-nexplanon
Mayoclinic. Contraceptive implant. https://www.mayoclinic.org/tests-procedures/contraceptive-implant/about/pac-20393619
Electronic medicines compendium (emc). Nexplanon 68 mg implant for subdermal use. https://www.medicines.org.uk/emc/product/5720/smpc#gref
FDA approved patient labeling. https://www.merck.com/product/usa/pi_circulars/n/nexplanon/nexplanon_ppi.pdf
Australian Family Physician. Implanon NXT: Expert tips for best-practice insertion and removal. https://www.racgp.org.au/afp/2017/march/implanon-nxt-expert-tips-for-best-practice-insertion-and-removal/
NHS. Contraceptive implant. https://www.nhs.uk/conditions/contraception/contraceptive-implant/
Planned Parenthood. Birth Control Implant. https://www.plannedparenthood.org/learn/birth-control/birth-control-implant-nexplanon
Mayoclinic. Contraceptive implant. https://www.mayoclinic.org/tests-procedures/contraceptive-implant/about/pac-20393619
Complete List
Top Does It Matter Where Nexplanon Is Inserted? Related Articles
Birth Control Options
Birth control is available in a variety of methods and types. The method of birth control varies from person to person, and their preferences to either become pregnant or not. Examples of barrier methods include barrier methods (sponge, spermicides, condoms), hormonal methods (pill, patch), surgical sterilization (tubal ligation, vasectomy), natural methods, and the morning-after pill. Side effects and risks of each birth control option should be reviewed before using any birth control method.
Choosing Your Birth Control Method
Which birth control option is right for you? Discover birth control methods such as birth control pills, birth control shot, implant, patch and more. Learn about birth control side effects and effectiveness.
Birth Control Pill vs. Depo-Provera Shot
Birth control pills (oral contraceptives) and the Depo-Provera shot are two hormonal methods of birth control. Both methods work by changing the hormone levels in your body, which prevents pregnancy, or conception. Differences between "the pill" and "the shot." Birth control pills are available as combination pills, which contain the hormones estrogen and progestin, or mini-pills that only contain progestin. In comparison to the Depo-Provera injection, which prevents pregnancy for three consecutive months. Both methods of birth control are very effective in preventing pregnancy. Both the combination pill (if you take them as directed) and shot are up to 99% effective in preventing pregnancy. While the mini-pill is only about 95% effective in preventing pregnancy. Both methods cause weight gain, and have other similar side effects like breast pain, soreness or tenderness, headaches, and mood changes. They may lead to decreased interest in sex in some women. There are differences between the other side effects of these methods (depending upon the method) that include breakthrough bleeding or spotting, acne, depression, fatigue, and weakness. Both oral contraceptives and the Depo-Provera shot have health risks associated with them, such as, heart attack, stroke, blood clots, and cervical cancer. Birth control pills appear to increase the risk of cervical cancer. Talk with your OB/GYN or other doctor or health care professional about which birth control method is right for you.
Birth Control Quiz: Test Your Medical IQ
What is the best form of birth control? Take this quiz to find out about hormonal, surgical, barrier, and natural methods!
DVT and Birth Control Pills (Oral Contraceptives)
Deep vein thrombosis (DVT) is a blood clot that has traveled deep into the veins of the arm, pelvis, or lower extremities. Oral contraceptives or birth control pills can slightly increase a woman's risk for developing blood clots, including DVT. DVT symptoms and signs in the leg include leg or calf pain, redness, swelling, warmth, or leg cramps, and skin discoloration. If a blood clot in the leg is not treated, it can travel to the lungs, which can cause a pulmonary embolism (blood clot in the lung) or post-thrombotic syndrome, both of which can be fatal if not treated immediately. Increased risk factors for DVT and birth control pills include over 40 years of age, family history, smoking, and obesity. Other medical problems that increase the risks of blood clots, for example, lung or heart disease, or inflammatory bowel disease or IBD (Crohn's disease and ulcerative colitis (UC). Other options for preventing pregnancy include IUDs, birth control shots, condoms, diaphragms, and progestin-only oral contraceptives.
What Does Birth Control Do to Your Body?
Different birth control methods work in different manners. No birth control method is perfect and every procedure or method has a side effect.
What Is the Best Form of Birth Control?
What's "best" among birth control methods differs from person to person. What's right for one person may not be right for others. And a person’s needs may also change over time.Which Birth Control Has Least Side Effects?
No form of birth control is free of side effects, but there are some that have the least noticeable ones.