Nexplanon (Contraceptive implant or rod)
Nexplanon is a small flexible rod that is placed just under your skin in your upper arm. It releases a hormone called progestogen and protects you from pregnancy for 3years.
How effective is it?
The implant is extremely effective – less than 1 woman in 1000 using Nexplanon will get pregnant over its 3 year duration of use.
How does it work?
The main way Nexplanon works is to stop the ovaries from releasing an egg each month.
Where can I go to get a Nexplanon inserted?
In Dumfries and Galloway you can get a Nexplanon inserted at a Sexual Health Clinic and some GP’s. If you are under 20 and attend a C2U clinic they may make arrangements for you to come to a Sexual Health Clinic for the insertion.
Can anyone have a Nexplanon?
Most women who want a Nexplanon can have it.
Conditions which may mean you may not be suitable for Nexplanon.
- Now or in the past you have had breast cancer
- You have had certain types of liver disease
- You have bleeding between the periods or after sex and you have not seen a doctor or nurse about this, or you have seen a doctor or nurse but you are still waiting to be told why this is happening
- You have certain rheumatic diseases
- Also you should stop using Nexplanon if you have a heart attack or stroke
How old do I have to be have a Nexplanon inserted?
Once your periods have started and you are in need of protection from pregnancy you can have a Nexplanon inserted.
What are the advantages of Nexplanon?
Some of the good things about Nexplanon are:
- Once inserted you do not need to think much about it
- There are no serious side effects
- You can use it if you are breast feeding
- It is useful if you cannot take oestrogens, like those found in the combined oral contraceptive pill
- Your normal level of fertility will return as soon as Nexplanon is removed
- It may reduce painful heavy periods
What are the disadvantages of Nexplanon?
Your periods are likely to change. In some women the periods will stop completely. Some women will have irregular periods or spotting between the periods and others may have bleeding that lasts a long time and can be heavy. See below for more information about what to do if you have problems with your bleeding.
Problems with your bleeding.
If you have problems with bleeding then discuss it with your doctor or nurse. They may wish to check the bleeding is not due to some other causes, such as infection. If the bleeding is thought to be due to the Nexplanon sometimes the best things is to wait and see since it can settle by itself. If the bleeding is very troublesome it may be that some tablets would help to control it. If you do decide to have your Nexplanon removed the bleeding problems should settle quite quickly
- When you start any contraception which contains hormones, you may get some annoying side effects in the first few months. With Nexplanon these include spotty skin, sore breasts, headaches, changes in mood and sex drive. These symptoms normally stop within a few months. Speak to your doctor or nurse if you have any concerns.
- Nexplanon will not protect you from sexually transmitted infections and many women continue to use condoms.
Are there any serious risks linked with using Nexplanon?
- There may be a small increase in the risk of breast cancer in women who have used hormonal contraception.
- You may have an allergic reaction to local anaesthetic or Nexplanon, or develop an infection at the site of insertion but these are all very rare.
When should I have the Nexplanon inserted?
It is usual to have an Nexplanon inserted within the first 5 days of your period. This means you will be immediately protected from pregnancy. If it is not possible to do this, your doctor or nurse will discuss other options with you. If you have it inserted after the first 5 days of a period you will not be protected from pregnancy for 7 days after the insertion.
How is a Nexplanon inserted?
Nexplanon is about the size of a short kirby grip. A specially trained doctor or nurse will insert it under the skin of your upper arm. A cold numbing spray or an injection of local anaesthetic into the skin to numb the area will be used to so that inserting the Nexplanon will not hurt. You will not have any stitches and it will only take a few minutes. The area may be a bit sore and bruised but it will have a dressing on it to help keep it clean and dry. Try not to knock it. After a few days you can remove the dressing and once healed you really should not be aware that it is there. You should be able to do all the things you would normally do with your arm. Usually you cannot see the Nexplanon but you are normally able to feel it.
Can anything make Nexplanon less effective?
- The common antibiotics a doctor or nurse gives you will not affect your Nexplanon. Antibiotics for TB (tuberculosis) and antibiotics to treat or prevent meningitis can affect Nexplanon as can some drugs used to treat epilepsy and HIV. The complementary medicine St John’s Wort can also make Nexplanon less effective. If you use any of these drugs it would better to use a different contraception and you should discuss this with your doctor or nurse. Always tell your doctor, nurse or dentist that you are using Nexplanon if they want to prescribe you any medicine.
- Diarrhoea and vomiting does not affect Nexplanon.
How is a Nexplanon removed?
It can be left in place for 3 years or it can be taken out sooner. A specially trained doctor or nurse will inject a small amount of local anaesthetic into the skin and will then make a small cut in the skin through which the Nexplanon will be removed. They will apply some paper stitches and a dressing to keep the area dry and clean. The dressing can be removed after a few days and the stitches can usually be removed after a week. The area may be a bit sore and bruised for a few days. If a Nexplanon is very difficult to feel under the skin it may not be so easy to remove. The doctor or nurse may refer you to a specialist centre to have it removed with the help of an ultrasound scan.
How long can I use Nexplanon for?
If you are happy with Nexplanon and have not developed any conditions for which you cannot use it then you could have an old one removed and a new one inserted every three years until you have reached the menopause.
It is important that you are happy with the type of contraception you choose to use. Doctors and nurses are trained to work with you to find a method of contraception that suits you. Do not be afraid to discuss any concerns you may have.