The implant ( brand name Nexplanon; previously Implanon) is a small rod that's inserted under the skin of a person's upper arm. It's so small, in fact, most people can't see it once it's inserted—which means it is a very private method. The implant releases progestin, a hormone that keeps the ovaries from releasing eggs and thickens cervical mucus—which helps block sperm from getting to the egg in the first place. It prevents pregnancy for up to four years.
Get it and forget it
No packages or prescriptions to pick up at the pharmacy, so there's nothing that could get lost or forgotten.
No one can tell who has the implant. There's no tell-tale packaging, and nothing that needs to be done before having sex.
The pregnancy question
A person's return to fertility should occur very quickly after implant removal, which is great for those looking to conceive. But for those who aren't ready or interested in getting pregnant, an alternative method will be required as soon as the implant is taken out.
Thanks to the Affordable Care Act, for those with health insurance, chances are good that the implant is available without out-of-pocket costs. Explore all insurance options at HealthCare.gov or at a state-based marketplace. For those without insurance or Medicaid, this method can be expensive up front. Still, the implant can stay in place for up to four years, so it becomes pretty economical over time, averaging about $10 a month if it stays in for the full four years.
- This method may be free or low-cost.
- With Medicaid: free.
- With insurance: free under most plans.
- Without insurance: depending on income, it may be possible to go to a low-cost clinic to get the implant at reduced cost.
The full price of the implant can range from $450 - $800. To see how this translates over time, here’s what it would cost to pay for the implant month-to-month at full price:
- Cost per month over one year: $38 - $67.
- Cost per month over four years: $10 - $17.
- Payment assistance: check with a local family planning clinic and find out if they offer free or low-cost implants (many do).
How to Use It
To get an implant a person will have to go to a health care provider to gather medical information and get a physical exam. The provider will number a small area in the patient's upper arm with a painkiller and then insert the implant under the skin. If insertion is done during the first five days of a person's period the implant becomes effective immediately. If it is inserted outside of that five day window, a back-up method (condom, internal condom, diaphragm, sponge, or emergency contraception) will be required to protect against unplanned pregnancy for the following week.
After insertion, the implant requires no maintenance, with the exception of checking occasionally to ensure that it can still be felt under the skin where it was placed.
When it's time to take the implant out, a health care provider will numb the arm again, make a tiny cut in the skin, and remove the implant. For those interested in continuing to use the implant, another one can be put in at the same time.
Every method has its own positives and negatives, and because everyone's birth control is different what one person experiences may not be the same as another's experiences.
- Doesn't interrupt the heat of the moment.
- Most people have fewer, lighter periods.
- You don't have to worry about remembering to take it every day.
- Your birth control is taken care of for up to four years.
- Safe for smokers and those with hypertension and diabetes.
- Can be used while breastfeeding.
- Can be used by those who can't take estrogen.
- May improve PMS, depression, and symptoms from endometriosis.
Everyone worries about negative side effects, but for many people, they're not a problem. Most folks adjust to having an IUD pretty quickly, but it could take a few months. For a very small number of people there are risks of serious side effects, however, so it's best to discuss those with a provider.
The most common complaint:
- Irregular bleeding, especially for the first 6-12 months. This could mean spotting in between periods or having longer, heavier periods. Some people have irregular bleeding the whole time the implant is in. On the other hand, others get no periods at all, at least for a while. A little unpredictable, but most folks seem to do okay.
Less common side effects:
- Change in appetite.
- A change in sex drive.
- Ovarian cysts.
- Discoloring or scarring on the skin over the implant.
- Hair loss.
- Pain where the implant was inserted.
- Sore breasts.
For those who have bad side effects that don't improve after six months, talk with a provider about switching to something that works better.