Etonogestrel (Nexplanon®) Implant

What is the etonogestrel implant (Nexplanon®)?

It is a long-acting, reversible form of birth control. It prevents pregnancy 99% of the time. It lasts up to 4 years. It is a small, flexible rod that goes under the skin of your upper inner arm.

What are benefits of etonogestrel implant (Nexplanon®)?

• Fewer than 1 in 100 women will get pregnant during the first year of using it.
• You do not need to take birth control daily.
• You can have it removed when you want to get pregnant. There is no impact on a future pregnancy.
• More than 80% of people who get an implant still use and like it after the first year.
• It costs less than other types of birth control if you use it for years.
• You will not have a scheduled period while the implant is in place. Most people do have some irregular and unpredictable spotting.

What are cons of etonogestrel implant (Nexplanon®)?

• The initial cost is higher than the cost of other methods. It is often covered by insurance.
• It needs to be removed by your provider.
• A change in your bleeding pattern is the most common side effect. Your bleeding may be longer or shorter during your periods. You may have no bleeding at all. The time between periods may change. You may have spotting. Some studies show 1 out of 10 women have this removed because of irregular bleeding.

Do not use etonogestrel implant (Nexplanon®) if you:

• Have an allergy to etonogestrel
• Are pregnant
• Have a history of breast cancer. heart disease, or liver disease

What if I become pregnant while using etonogestrel implant (Nexplanon®)?

It is very unlikely, but you can get pregnant while using this. Take a urine pregnancy test if you feel like you may be pregnant. Call the clinic right away if it is positive. We will need to see you right away.

How is the etonogestrel implant (Nexplanon®) placed?

• Your provider will numb the skin in your upper arm with a medicine. Then, it is put under the skin. 
• You will be given a card when your implant is placed. This will remind you when it expires. Your provider will also have a record of this if you lose your card.
• You will be able to feel it if you press your fingertips over it.
• You will need to use a backup birth control for 5 days after it was put in.

The first 1 to 2 weeks

• Small bandages, called steri-strips, were put on your skin is to prevent infection.
  • Cut them back as needed if they start to peel off.
  • Leave them on until they fall off.
• A small bandage was put over your implant site. Your arm was wrapped with a pressure bandage. 
  • Leave this on for at least 24 hours. It will help stop bruising.
  • Do not get this bandage wet.
• You may have bruising on your arm near the site. This is normal and will go away.

The first 6 to 12 months

• Your period may be irregular. It may be lighter, shorter, heavier, or longer.
• Your period may be heavier at first. The number of bleeding days may be more.
• You may have frequent spotting or light bleeding.
• Few women find their periods are heavier than normal.
  • Call your provider if your period stays heavier than normal.

After 12 months

Your body should be fully adjusted. Your period may:

• Be shorter and lighter than before
• Stay irregular with light spotting occasionally 
• Stop completely

After 4 years

It is effective at preventing pregnancy for up to 4 years. After this it is no longer effective. You may start having heavier periods.

• Have a health care provider remove it.
• You may get another implant if you would like.
• Do not try to remove it at home.

Call the clinic right away if you have:

• Pain that is getting worse.
• Redness or swelling at the site.
• Cannot feel the implant in your arm.

Go to an Emergency Room if your provider’s office is not open and you have:

• An allergic reaction:
  • Itching
  • Hives
  • Chest tightness
  • Trouble breathing
  • Swelling or tingling in your mouth or throat
  • Swelling in your face or hands
• Chest pain, trouble breathing, and coughing up blood
• Double vision or trouble seeing
• Numbness or weakness on one side of your body, sudden or severe headache, trouble seeing, talking, or walking
• Pain in your lower leg (calf)
• Severe or ongoing pain, tingling, bleeding, bruising, redness, itching, or swelling at the implant site
• Unusual or severe pain in your abdomen
• Unusual or unexpected vaginal bleeding, or heavy bleeding

Talk with your provider if you have these less serious side effects:

• Acne or pimples (this should get better over time)
• Mild headache
• Mild pain, tingling, bleeding, bruising, redness, itching, or swelling at the implant site. This will get better soon.
• Mood changes
• Weight gain

Call:

• Obstetrics Gynecology Clinic at (319) 356-2294
  • Monday to Friday from 8:00 a.m. to 4:30 p.m.
• For urgent questions
  • Call toll-free at 800-777-8442, 24 hours a day
  • Ask the gynecology resident on call.
  • You may be asked some questions when using the toll-free number

Send a MyChart message for non-urgent questions or concerns.