Answers to some common questions about Nexplanon (etonogestrel)

The Nexplanon implant is a long-acting, reversible contraceptive in the form of a small, flexible rod, which is inserted just under the skin on the inside of your upper arm. It contains the hormone progestogen, a small amount of which is released into your body each day. This prevents the monthly release of eggs from your ovaries. So, if there are no eggs to fertilise, you cannot become pregnant.

No method of contraception is 100% effective. However, the Nexplanon implant inhibits ovulation and is more than 99% effective, and is therefore a very reliable method of contraception.

Yes, it is possible to change your contraception to the contraceptive implant from another method of contraception such as a combined oral contraceptive pill, a progestogen-only pill, an intrauterine device or an injectable contraceptive. Your doctor or family planning nurse can help you decide whether the Nexplanon implant is suitable for you. They will explain the insertion procedure and most suitable time for you to switch.

In general, the contraceptive implant should be inserted between the first and fifth days your menstrual cycle. This may vary, however, according to the type of contraceptive you are using at the time.

The Nexplanon implant starts to work as soon as it is inserted, providing the procedure is conducted at the appropriate point in your menstrual cycle.

You will probably be given a local anaesthetic to numb the area while the procedure takes place. However, the area may be a little tender and bruised when the anaesthetic has worn off. This should ease relatively quickly.

The Nexplanon implant is unlikely to be visible. However, you should be able to feel that the Nexplanon implant is in place with your fingertips. It is important to be able to feel it in position when it is time for it to be removed.

When correctly inserted, the Nexplanon implant lies in the tissue just below the surface of your skin. This holds it in position and it should not get lost. Because the Nexplanon implant is made of a flexible plastic, it is unlikely to break inside your arm.

Your doctor or family planning nurse will advise when you need to attend the clinic for routine check ups.

Some medicines may affect the efficacy of the contraceptive implant. This includes drugs used to treat epilepsy, some antibiotics, treatments for tuberculosis and the herbal remedy St. John’s Wort. It is important that you remember to tell your doctor or pharmacist that you are using the Nexplanon implant when other medicines are being prescribed for you, or when you buy over-the-counter medicines. Also remember to tell the doctor or nurse who attends to you if you have to have treatment in hospital.

Yes. Because the Nexplanon implant is not taken by mouth it will continue to work even if you vomit or have diarrhoea.

No, the Nexplanon implant has no known effect on the density of your bones. This is because the level of estrogen in your body remains at a sufficient level to maintain healthy bone mass.

The Nexplanon implant cannot protect you from sexually transmitted infections. You should use condoms if you are concerned that you may be at risk of a sexually transmitted infection.

As with most medicines, there is a possibility of some side effects with the Nexplanon implant. Those most commonly reported include acne, breast tenderness and pain, headaches, irregular vaginal bleeding, vaginal infection and weight changes. However, not all women will experience these side effects or to the same degree. Please read the Nexplanon Patient Information Leaflet for more information on possible side effects, and discuss any concerns that you may have with your doctor or family planning nurse at any time.

No. Once the contraceptive implant is removed your fertility should return to a level that is normal for you and for your current age.

As with all hormonal contraceptives, some women notice changes in their weight while using the contraceptive implant.

As with other progestogen-only methods of contraception, some women find their periods happen only occasionally, or may stop completely, when using the Nexplanon implant. This is quite normal. Others find that their periods become heavier or last longer. It’s also possible that your bleeding pattern may change the longer you use the contraceptive implant. It is impossible to predict these changes and, although they may be inconvenient, they are not harmful and do not mean that the Nexplanon implant is not working. If you have concerns about your bleeding pattern, talk to the healthcare professional who fitted Nexplanon.

Instances of mood change have been reported with all forms of hormonal contraception. Consult your doctor or family planning nurse if you are concerned.

The Nexplanon implant must be removed after 3 years or sooner if you are above average weight. When the contraceptive implant is inserted you will be given a card that states the date by which the Nexplanon implant should be removed. Please keep the card somewhere safe, and make an appointment with your doctor before this date. You can also sign up for our free e-mail alert service to help you remember when you should think about having the Nexplanon implant removed.

To remove the contraceptive implant a trained healthcare professional will first feel the position of the implant with their fingertips. A local anaesthetic will then be used to numb the area before a small incision is made in the skin at one end of the implant. The implant will then be gently pushed through the incision and removed. After the implant is removed, a pressure bandage may be applied to minimise any bruising.

Nexplanon is a single-rod contraceptive implant and its removal by a trained healthcare professional should take only a few minutes.

Yes. If you decide to continue to use Nexplanon, a new contraceptive implant may be inserted at the same time as the old one is removed. If you do not continue to use Nexplanon, you will need to start using another form of contraception immediately if you do not wish to get pregnant.

Nexplanon should only be fitted and removed by healthcare professionals who are specially trained in this procedure. Ask whether your doctor or nurse is trained to remove Nexplanon. If they are not, they will refer you to another clinic that is able to remove Nexplanon.

There is a slight possibility that a scar may be left by the incision used to remove Nexplanon.

Your doctor or family planning nurse can help answer any further questions you may have about the Nexplanon implant and contraception. You could also visit the links given on the Nexplanon (etonogestrel) and Contraceptive Choices page of this website.