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Contraceptive Implant (Nexplanon)


Etonogestrel Contraceptive Implant



The Nexplanon contraceptive implant is a flexible, ethylene vinyl-acetate copolymer (plastic) tube 4 cm long by 2mm wide that gets inserted under the skin of your upper arm by your healthcare provider in a quick office-based procedure. It then releases progestin called etonogestrel, a type a progesterone like the one your body makes, to prevent pregnancy.

How Does It Prevent Pregnancy?

  • The etonogestrel implant stops the ovaries from releasing an egg, prevents the sperm from meeting an egg by changing the cervical mucus, and also thins out the uterine lining, preventing implantation. The medication is slowly released over time.

  • It is more than 99% effective at preventing pregnancy. Unlike short-acting methods like the pill, there is nothing to remember, the implant is always there until it is removed by your health care provider.

  • Implants do not affect the ability to become pregnant after having it removed. Pregnancies have been reported as soon as 5 days after a removal.

  • It does not contain estrogen, and is appropriate for women who are breastfeeding who do not wish to become pregnant.


Menstrual Changes

  • Side effects from the implant are usually mild. The most common side effect of the etonogestrel implant is irregular uterine bleeding. This can look like longer or shorter bleeding during your period, no bleeding at all during the time of your period (amenorrhea), spotting between your periods, and varied amounts of time between your periods. For most people, the bleeding is lighter than their usual periods.

  • 1 in 10 users will have nuisance bleeding which causes them to discontinue use of the implant (having it removed by their health care provider).


Risks & Side Effects

  • The most common side effect is irregular bleeding/spotting (as above).

  • Complications associated with the Implant are rare but may occur. The most common risks complications of inserting an Implant include irregular bleeding or spotting and problems with insertion and/or removal.

  • Implants can produce similar side effects as oral birth control pills, such as bloating, breast tenderness, nausea, or mood changes, but these should disappear within the first 3 months following the insertion.

  • If at any point after the insertion you are unable to feel the Implant or feel that it is broken or bent, make an appointment to have the doctor do an exam to feel for the implant and/or removal. In the meantime, you should use a backup form of barrier birth control, such as condoms. Nexplanon includes a small amount of a material that is detectable by an X-Ray in the instance that the implant cannot be felt by hand.


Cost & Duration of Use

  • Nexplanon can remain in place for up to three years; it can be removed at any time before then.

  • The Nexplanon cost is approximately $350.00 plus pharmacy dispensing fees; the device is covered by most private insurance plans.

  • The Implant (Nexplanon) is new to Canada (approved in 2020, although it has been used for many years in other countries), which means that private insurance may not cover it yet. Before considering Nexplanon, you may want to contact your insurance company to make sure that it is covered.

Contraception: Features
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