How does the contraceptive implant work?


You’re probably familiar with the pill and how it works, but long-acting reversible contraceptives (LARCs), including the contraceptive implant (aka Nexplanon), don’t require daily checks on your to-do list.

There is a growing interest in the etonogestrel contraceptive implant, and its set-and-forget nature likely plays a role in this. Once the small rod is placed in your arm, you don’t have to think about your contraception for years. Add to that the fact that it is very effective in preventing pregnancy and is an attractive contraceptive option, especially since the right to abortion and other forms of essential reproductive care are under threat in many states across the country.

So how does the contraceptive implant work? Here’s what you need to know if you’re looking to upgrade to a LARC and want to explore your options.

How does the contraceptive implant work?

LARCs, which include the herbal contraceptive and intrauterine devices (IUDs), are the most effective reversible contraceptive methods, according to the American College of Obstetricians and Gynecologists (ACOG). LARC methods have a high success rate for preventing pregnancy while they are in place, but they should not have a direct impact on your return to fertility; once the implant is removed, for example, you can get pregnant quickly if you don’t have other factors affecting your fertility, Christine Greves, MDa gynecologist at Winnie Palmer Hospital for Women and Babies in Orlando, says SELF.

The contraceptive implant is quite small – it measures just under 2 inches long and is about the size of a match. « Nexplanon is a small stem of a synthetic progesterone [progestin] which goes under the skin, Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology and reproductive sciences at the Yale School of Medicine, tells SELF. The implant is inserted into the upper part of your non-dominant arm, where it can remain for up to three to five years, depending on the ACOG.1 (Don’t worry, your healthcare provider should numb the area so you won’t feel any discomfort during this process.)

The way it works is pretty cool: « The implant sends [progestin] in the bloodstream, which reaches the ovaries to help suppress ovulation,” says Dr. Minkin. « Also, [progestin] helps keep cervical mucus hostile to sperm, which helps prevent sperm from moving up into the uterus.

Like any form of birth control, contraceptive implant can come with potential side effects such as bleeding between periods, longer or shorter bleeding during your period, heavier or lighter flow, time gaps variables between the rules or no rules at all, depending on Planned parenthood. Other possible side effects include the usual: headaches, breast pain and nausea, among others. « As long as you’re okay with the possibility of irregular bleeding…it’s a phenomenal form of birth control, » says Dr. Greves.

How effective are contraceptive implants in preventing pregnancy?

In general, « the implant is a good option for people who know they want to delay pregnancy for several years and don’t want to have to take a pill every day », Alexa M. Sassin, MDassistant professor of obstetrics and gynecology at Baylor College of Medicine in Houston, says SELF.

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