Nexplanon is a contraceptive implant: a small flexible rod placed under the skin of the upper arm, releasing the progestogen etonogestrel steadily over several years. It is highly effective and needs nothing remembered day to day.
One practical difference from the older Implanon: Nexplanon contains a small amount of material that shows up on X-ray, so if it cannot be felt it can still be located by imaging. That was a real difficulty with earlier implants and is worth knowing if you have ever been told yours cannot be found.
Common hormonal medicine side effects
- Changes to bleeding, the most common effect and the most common reason for removal
- Headaches
- Acne, which may appear or improve
- Breast tenderness
- Mood changes
- Weight change
- Bruising, tenderness or swelling at the insertion site for a few days
Containing no oestrogen, it can usually be used by people who cannot take combined pills, including those with migraine with aura, and it does not carry the same clot risk.
Bleeding, mood, skin, weight and cycle changes
Bleeding is unpredictable and varies widely. Some people have infrequent or no bleeding, some have regular bleeding, and some have frequent or prolonged bleeding. There is no way to know in advance which you will get, and unlike a hormonal coil, the pattern that emerges early tends to be the pattern that persists.
Troublesome bleeding is often treatable, so it is worth asking before assuming removal is the only option. See implant bleeding side effects.
Fertility returns quickly after removal.
Serious warning signs that need medical attention
- Signs of infection at the site: increasing pain, redness, swelling, heat or discharge
- Not being able to feel the implant. Use additional contraception and contact your clinic, where it can be located by imaging if needed.
- The implant appearing to have moved, or becoming painful or visible
- A missed period with abdominal pain, which needs assessment
- Heavy or prolonged bleeding affecting daily life
- Yellowing of the eyes or skin, or a severe headache unlike your usual
Who may be at higher risk?
Tell your clinician about unexplained vaginal bleeding, liver conditions or a history of breast cancer. Some epilepsy medicines, rifampicin and St John’s Wort can reduce effectiveness, in which case a coil may be suggested instead. See St John’s Wort and birth control.
It does not protect against sexually transmitted infections.
What to discuss with your doctor, pharmacist or clinic
- What can be done if the bleeding pattern is unmanageable?
- When is it due for replacement or removal?
- How should I check I can still feel it?
- Do any of my medicines reduce how well it works?
- How soon does fertility return after removal?
Related contraception, HRT and hormonal medicine guides
- Hormonal contraception side effects
- Hormonal medicine side effects
- Women’s health and hormonal medicine side effects
- When to see a doctor about hormonal medicine
- Report a hormonal medicine side effect
See also Implanon, contraceptive implant side effects and implant removal.
Medical Disclaimer: This content is for informational and educational purposes only and does not constitute medical diagnosis, prescription, or professional advice. Always read the patient information leaflet and consult a qualified doctor or pharmacist regarding any medicine or health concern.