You’ve probably heard a lot about IUDs recently. But have you heard much about Nexplanon, a.k.a. the birth control implant?
Like the IUD, the Nexplanon implant is tiny, discreet, hassle-free, and over 99% effective at preventing pregnancy. The difference is where it sits in your body — instead of being placed inside the uterus, the implant is inserted under the skin of the inner upper arm.
We’re eager to get the word out about the contraceptive implant — and make sure folks have access to accurate information about their options so they can make informed decisions regarding their health care. For that reason, we’ve compiled a post of frequently asked questions related to the birth control implant. Check ’em out below — and give us a call any time at 1-(855)-SAY-CARA to make an appointment or ask us a question.
1. What is a contraceptive/birth control implant?
The contraceptive implant is a small, simple, matchstick-sized method of birth control. The implant is inserted under the skin of the bicep (inner upper arm) and is one of the most effective ways to prevent pregnancy for up to 4 years. Don’t necessarily need or want 4 years of pregnancy coverage? No worries — the implant can be quickly and easily removed at any time prior if you want to get pregnant or switch methods of birth control. And even though the implant is inserted in your upper arm, no surgery or heavy painkillers are needed for the 10-minute procedure — so you can continue your day as normal once it’s in.
2. Is the implant safe?
Yes! The hormonal implant extremely safe — and it’s over 99% effective at preventing pregnancy.
3. How long does an implant protect you from pregnancy?
According to Nexplanon, who manufactures the implant, the hormonal implant is effective for up to 3 years — but new research shows it is good for up to 4. The implant is over 99% effective at preventing pregnancy — meaning it’s on-par with the IUD and more effective than birth control pills when it comes to pregnancy prevention — and can be removed at any time prior if you want to get pregnant or switch methods of birth control.
4. How much does a birth control implant cost?
The cost of birth control implants like Nexplanon varies from provider to provider. In the long term, contraceptive implants are very cost-effective! But in the short term, without insurance, they can run anywhere from $700 to $1,000. We accept many types of insurance at carafem, and most insurance plans, including Medicaid, cover the cost of birth control implants in full thanks to the Affordable Care Act.
If you don’t have insurance, you may want to look into the option of getting an implant from your local Title X clinic, which may offer sliding scale prices for services depending on your income. If it’s helpful, you can call us at 1-855-SAY-CARA to talk pricing in more detail.
5. Why are implants so expensive?
We understand that implants can be very costly, but at carafem, we work hard to reduce the cost of our birth control methods. We also take insurance — and if you have insurance, your birth control costs may very well be covered under the Affordable Care Act (aka Obamacare).
If you don’t have insurance, you may want to look into the option of getting an implant from your local Title X clinic, which may offer sliding scale prices for services depending on your income. carafem also offers birth control pills for $12 a month for uninsured folks — so even if an implant isn’t affordable right now, we can keep you covered until it is.
6. I don’t have insurance and can’t afford to pay the high out-of-pocket cost. Where can I get a birth control implant for cheap?
If you don’t have insurance, we recommend looking into the option of getting an implant from your local Title X clinic, which may offer sliding scale prices for services depending on your income. Title X clinics receive government funding for family planning, which means they can sometimes offer lower prices to people who need assistance. You can refer to this list to find a Title X clinic near you — or by doing a quick Google search. carafem also offers birth control pills for $12 a month for uninsured folks — so even if an implant isn’t affordable right now, we can keep you protected from pregnancy until it is.
7. I have insurance, so my implant should be free! Yay! But will I have a co-pay?
According to the guidelines of the ACA at the time of this blog, “Plans must cover these services without charging a copayment or coinsurance when provided by an in-network provider — even if you haven’t met your deductible.” So as long as you’re being seen by a provider in your network, your implant should be free — and you shouldn’t be charged a co-pay.
8. How long does it take to insert an implant? Does it require surgery or anesthesia?
At carafem, appointments for implant insertion usually last less than an hour, and the hormonal implant takes only a few minutes to insert. No surgery is required — only local anesthesia is needed to keep you comfortable.
9. Does implant insertion hurt?
Insertion pain is different for everyone, but most people report feeling pressure rather than pain. Before inserting the implant, your clinician will inject the area with a small amount of numbing medication to make you more comfortable.
10. How long does it take for a hormonal implant to be effective once inserted?
The hormonal implant is effective immediately only if you get the implant inserted within the first 5 days of your menstrual period. If you have your implant inserted when you’re not on your period or have already passed the first 5 days of your period, you will need to use an additional method of birth control (like condoms) if you have sex at any time in the first 7 days following your insertion. After that, you’re super protected from pregnancy with the implant alone!
11. Does the contraceptive implant protect against sexually transmitted infections (STIs) or diseases?
No. The implant only prevents pregnancy. In order to stay protect yourself from illnesses like HIV, chlamydia, and gonorrhea, you’ll still need to use a condom every time you have sex — and make sure you and your partner(s) are tested regularly for STIs.
12. I heard you have to be on your period to get an implant inserted, but I want one ASAP. Can I still get one?
Definitely! You can get an implant inserted at any time of the month, regardless of where you are in your menstrual cycle. There is one major benefit of getting an implant inserted within the first 5 days of your period, though — which is that the hormonal implant is effective immediately if you get the implant inserted within the first 5 days of your menstrual period. If you have your implant inserted when you’re not on your period or have already passed the first 5 days, you will need to use an additional method of birth control (like condoms) if you have sex any time in the first 7 days following your insertion. After that, you’re super protected from pregnancy!
13. Does the implant cause an abortion?
No! The hormones released in the implant block ovulation (the release of an egg from the ovary) from occurring, so there are no eggs to be fertilized. No released egg, no fertilization, no pregnancy, no abortion.
14. Why do you need to have an implant replaced after 3-4 years?
Just like any medication, implants can expire and become less effective over time. Getting an implant replaced when recommended helps ensure its efficacy and helps keep you pregnancy-free when you want to be.
15. What’s the difference between the implant and other forms of birth control (pill, IUD, etc.)?
Hormonal implants are tiny, hassle-free, very effective at preventing pregnancy, and invisible once they are inserted under the skin of your upper arm. An implant is a great option for many reasons — but especially if you’re not thrilled about dropping trou for long-acting, reliable birth control. Once in place, the implant prevents pregnancy for up to 4 years.
IUDs are similar to implants in that they are tiny, invisible, hassle-free, and super effective at pregnancy protection. Their location is different, though — instead of being placed in the upper arm, the IUD is inserted into the uterus (through the vagina and cervix). One amazing thing about IUDs is that they prevent pregnancy for anywhere between 3-12 years. Like the implant, they are over 99% effective at preventing pregnancy, and a lot of people like them because they’re also hassle-free. There are also two types of IUDs — hormonal, like the implant, or completely hormone-free. Unlike birth control pills, which need to be taken every single day in order to be effective, IUDs require almost no user maintenance once they’re in place.
16. What are the chances I’ll have some scary issue with my implant?
While implants are extremely safe and effective, no method is 100% perfect. Most people have no issues with their implant — but just like any medication or device, some will.
The most commonly reported side effect of the hormonal implant is irregular bleeding, especially during the first 6-12 months after it is inserted. Bedsider elaborates: “This could mean spotting in between periods or having longer, heavier periods. Some women have irregular bleeding the whole time the implant is in. On the other hand, some women get no periods at all, at least for a while. A little unpredictable, but most women seem to do okay. Bottom line: you need to be okay with irregular periods if you are thinking about the implant.”
In rare cases, some people experience serious issues with the implant. Again — this can be said about almost any medication or medical device. To see a full list of possible, though rare, issues with the hormonal implant, check out Nexplanon’s site.
17. Who can get an implant? Can you get an implant if you haven’t had kids?
Yes, you can get an implant if you haven’t already had kids! Research today shows contraceptive implants can be used by most healthy adults with uteruses; regardless of whether or not you’ve given birth before! Unsure if you’re a good candidate for the implant? Make an appointment to be seen at carafem so we can assess your personal situation: 1-(855)-SAY-CARA
18. What are the side effects of hormonal implants?
Just like any medication, everyone’s experience with the implant is different, and the hormonal implant can come with both positive and negative side effects. Implants can cause shorter, lighter, and less frequent menstrual periods, which some folks really like. The implant can also improve symptoms of PMS, depression, and issues related to endometriosis.
Fewer people have reported unpleasant side effects, like acne, change in appetite, or a change in sex drive, especially within the first few months of getting an implant. These symptoms can be associated with most forms of hormonal birth control. If you’re looking to avoid hormones and any symptoms that may be associated with them, consider the copper IUD. It is totally hormone-free and prevents pregnancy for up to 12 years.
19. Why can an implant cause irregular bleeding? If my period isn’t regular, how will I know if I get pregnant?
Hormonal birth control, like the implant, can make periods lighter and/or less regular by causing less uterine lining buildup. Over time, this can cause some people to have little or nothing to shed when they’d normally have a period. The amount of uterine lining present can change month-to-month, which can cause irregular bleeding. And while irregular bleeding or not having a period at all because of the implant can be a nuisance, it isn’t dangerous — it’s purely an effect of the medication.
Once you stop using the implant, it’s very likely your menstrual cycles will return to the way they were before you started hormonal birth control. For those who continue to have ongoing irregular bleeding that they find concerning, talk to your doctor as you may be able to receive further treatment options to help control.
Since implants are so effective at preventing pregnancy, becoming pregnant with one properly in place is extremely rare — but it can happen.
If you experience ongoing symptoms of pregnancy, such as nausea/vomiting, irritability fatigue, or breast tenderness, frequent urination, unusual bleeding — and you’ve missed your period — you may want to take a pregnancy test for peace of mind. And if having a regular period is important to you, a hormone-free method of birth control, like the copper Paragard IUD, might be a better choice for you.
20. Will the hormonal implant make me gain weight?
While weight gain is often cited as a side effect of birth control, the truth is that there are many other reasons our weight tends to fluctuate during our lives. Changes in diet, activity, and routine are a big one. According to our friends at Bedsider, “Early studies showed that about 5% of women using the implant got them removed due to concerns about weight gain. However, the weight changes don’t appear to be different between women using the implant and women using birth control without hormones.”
Each method of birth control affects each person differently, but as a whole, weight gain is not a common side effect of birth control implants. In fact, the Depo-Provera shot is the only method of birth control that has a proven connection to slight weight gain. If you are concerned about side effects associated with hormonal birth control, you may want to consider trying a non-hormonal IUD.
21. Will the implant make me infertile? If not, how long will it take to get pregnant afterwards?
No. Like all FDA-approved methods of birth control available today, the hormonal implant has been rigorously tested for both long- and short-term side effects. Like the IUD, the birth control implant only protects against pregnancy when it’s in your body. Once it’s removed, your body returns to its natural ability to conceive, and you may be able to get pregnant as soon as right away — so make sure to use another form of birth control if that’s not what you want! For some folks, it can take up to two months after the implant is removed to return to their regular menstrual cycle and fertility.
22. I want great birth control now, but want to get pregnant in 1-2 years. What if I want my implant removed before the 3-4 years it’s good for?
You’re in luck! While birth control implants are effective for up to 4 years, you can have it removed at any time if you decide you want to get pregnant or simply want to change your birth control method. Removal is even quicker and easier than insertion.
23. What it is like having the Nexplanon implant removed?
Like having it inserted, having your Nexplanon taken out is quick and easy. Your clinician will administer a shot of local anesthesia to numb the area. Then, a small incision is made and the implant is removed. Once it’s out, you can choose to have a new implant inserted or switch to a new method of birth control if you’d like to stay protected from pregnancy.
24. How much does it cost to have a Nexplanon implant removed?
Prices for implant removal tend to vary depending on the provider. While the procedure is often covered by insurance under the Affordable Care Act (aka Obamacare), it’s a good idea to contact your doctor’s office to ask about price. If you don’t have insurance, you may want to look into the option of getting your implant removed by your local Title X clinic, which may offer sliding scale prices for services depending on your income. It’s always your right to stop a birth control method, regardless of your income level, which is why services are made affordable and accessible to people who need them.
25. How do you know if the implant is in the right place?
Once the implant is inserted, your clinician should show you how to feel it by pressing on the insertion site. Most people can feel their implant since it’s placed just under the skin, but not everyone can. If you notice you one day can no longer feel your implant when you previously could, don’t freak out — there’s no way to expel an implant or have it come out of your body on its own. Still, if you’re concerned or just want to double-check that everything is in place, it never hurts to make an appointment to see your doctor.
26. Is it safe to have an implant while breastfeeding?
Yes! Better yet, you can get an implant inserted right after giving birth — either directly following delivery or during a post-partum checkup.
27. I don’t like the idea of something being implanted in my arm/not being able to easily check if it’s really there. Are there other hassle-free, super-effective options out there besides the implant?
Yes! If you want long-lasting birth control but aren’t thrilled about the idea of something being implanted in your arm — especially something you can’t see or feel to make sure it’s still where you want it to be — we recommend trying an IUD. While the IUD is also invisible to the naked eye, since it sits inside the uterus, you can check to make sure it’s in place by feeling for the strings attached to it. IUDs are also a great option for folks looking for very low-hormone or hormone-free long-lasting birth control.
If you aren’t ready for an IUD or implant, or just don’t think a long-term method of birth control is right for you, remember that there are lots of other effective methods of contraception available — they might just require you to put more effort into staying pregnancy-free. It’s also good to keep in mind that there is no one method of birth control that works perfectly for every single person — otherwise everyone would using it! Finding the right method for you may take some trial and error, but don’t give up. We’re happy to help you find the best option for you.
28. I’ve had pain or other issues that started after getting my implant inserted. Do I have to get my implant taken out?
There are lots of reasons our bodies might experience pain or other issues. And while it may seem obvious to link newly developed issues to the implant, it might not be the culprit — so it’s important to consult your doctor for their opinion.
While certain issues, like spotting and cramping, are common within the first months after insertion, serious pain or other unusual symptoms are cause to see your doctor. It’s your right to get timely medical care for issues that are bothering you, and you deserve to know the root cause of any trouble you encounter. If your doctor can’t find a reason for the pain — and you want to make sure it’s not related to your implant — you can always have it removed and give another method a try, like the IUD.
29. Do birth control implants increase your chances of breast cancer?
Lots of research has been done on progestin, the hormone in the implant that makes it work, and there have been no conclusive studies showing a link between breast cancer and the hormone in birth control implants. Research surrounding other types of progestin birth control backs this up. According to our friends at Bedsider, studies of the birth control shot, a.k.a. Depo-Provera, show “that there is no increased risk of breast cancer, even when women used the shot for multiple years.”
This is important because the amount of progestin hormone in the shot is much higher than it is in the implant. So if there’s no cancer link in a higher dose, there’s none in a smaller dose, either.
30. Do birth control implants increase your chances of an ectopic pregnancy?
You may have heard of the risk of ectopic pregnancy, or pregnancy occurring outside of the uterus when looking into various birth control methods. One important thing to note is that ectopic pregnancy can happen to any sexually active, uterus-having person, regardless of whether or not they use birth control. And as a matter of fact, using hormonal birth control actually decreases this risk of ectopic pregnancy, since it greatly decreases your chances of any type of pregnancy.
31. Will I have a scar from the birth control implant — either from insertion or removal?
There is a chance that removing the Nexplanon implant can cause a small scar on your inner upper arm. With proper care and good hygiene, though, most people don’t notice a scar from their implant.
32. Can a birth control implant bend or break inside your arm? What happens if it does?
Yes, it is possible for the birth control implant to bend or even break. If you think your implant has changed shape or broken, it’s a good idea to see your doctor to determine whether or not you need to have it replaced. Even if your implant does break, though, don’t freak out — the implant is still effective if broken, and no mega-dose of hormones will be released into your system from the breakage. The main concern if an implant breaks is that is might be a bit more difficult to remove when the time comes — but a broken implant is generally not detrimental to your health or the implant’s effectiveness.
Feeling like you’re ready to get an implant, or have more questions you’d like to ask in person? Give us a call any time at 1-(855)-SAY-CARA to make an appointment.
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carafem medical standards and guidelines have been composed and approved by Board-certified Ob/Gyn Physicians as part of the carafem medical committee. Still have questions? Check out our FAQ page, or call us at 855-SAY-CARA, or find a location near you.