The Contraceptive Implant (Nexplanon): How It Works & What To Expect
Medically reviewed by
Dr. IkejiLast reviewed: 14 Jun 2025
Hormonal contraceptives are popular birth control methods that use hormones to prevent pregnancy. They do this in a combination of ways, usually by preventing ovulation, thickening cervical mucus, and thinning the womb lining. Some types, like the combined or mini pill or the contraceptive patch, rely on you remembering to take it daily or change it weekly.
Methods like the contraceptive implant are a convenient choice if you are looking for an effective, long-lasting way to prevent pregnancy that can also be removed at any time, and your fertility will return to normal. It is also suitable if you cannot take oestrogen.
In this guide, you can find out all about what the contraceptive implant is, how it works, its benefits, and how you can get it.
- 1. What is the contraceptive implant?
- 2. How does the contraceptive implant work?
- 3. How the contraceptive implant is fitted
- 4. Effectiveness of the contraceptive implant
- 5. Side effects and risks
- 6. Benefits of the contraceptive implant
- 7. Comparing the implant to other contraceptive methods
- 8. How to get the contraceptive implant
- 9. Conclusion
- 10. FAQs
What is the contraceptive implant?
The contraceptive implant is an effective, long-acting, reversible type of contraception. It looks like a small, flexible, plastic rod around 4cm long and is inserted under the skin of the upper arm by a doctor or nurse. The implant steadily releases a synthetic version of the hormone progesterone and remains effective for 3 years.
In the UK, the contraceptive implant is available on the NHS under the brand name Nexplanon.
How does the contraceptive implant work?
The contraceptive implant releases a synthetic form of the hormone progesterone, called etonogestrel, into your bloodstream. A small amount of etonogestrel is continuously released into your bloodstream and works to stop you getting pregnant in 3 ways:
- Stopping your ovaries from releasing an egg each month (ovulation).
- Thickening the cervical mucus, making it more difficult for sperm to move through the cervix.
- Thinning the womb lining, making it difficult for a fertilised egg to implant itself.
How the contraceptive implant is fitted
The contraceptive implant or Nexplanon should be inserted and removed by a trained healthcare professional, such as a doctor or nurse.
How Nexplanon is inserted:
- You will need to lie on your back with your arm bent at the elbow and your hand underneath your head.
- The implant will be inserted into the inner side of the arm you do not write with.
- The doctor or nurse will mark where the implant will be inserted, and the area will be disinfected and numbed with anaesthetic.
- The skin is stretched, and a needle is inserted directly underneath it. Once the tip is inside, the needle is completely inserted parallel to the skin.
- The purple slide is unlocked to remove the needle, leaving the implant in your upper arm.
- The implant’s position can be checked by your doctor or nurse, who will feel for it after inserting it. A correctly inserted implant will be felt between your thumb and finger.
- A small adhesive bandage will be placed over the site, and a pressure bandage applied to minimise bruising. The pressure bandage can be removed after 24 hours, and the small adhesive bandage after 3 to 5 days.
- Once your implant is inserted, the healthcare professional will give you a Patient Alert Card with the insertion site, date, and the latest date the implant can be replaced or removed. You should keep this in a safe place as you’ll need it when you have the implant removed.
When can I start using the contraceptive implant?
The contraceptive implant should be inserted on days 1 to 5 of your period to rule out pregnancy and to provide immediate protection.
If the implant is inserted after day 5 of your period, you will need to use additional contraception, like condoms, for the 7 days.
When will the implant start working?
The implant will start working straight away if it has been fitted in the first 5 days of your period. If it has been fitted after this time, you will not be protected for 7 days after it has been inserted.
How long does the implant last?
Nexplanon, the only contraceptive implant available in the UK, lasts for 3 years until it needs to be replaced.
Effectiveness of the contraceptive implant
The contraceptive implant is more than 99% effective at preventing pregnancy and is comparable to the combined pill. However, if you do not get it replaced on time, usually after 3 years, its effectiveness will fall.
If you decide you would like to have a baby, your chances of getting pregnant will return to what they were before the implant was fitted immediately after removal.
Side effects and risks
Although the contraceptive implant is safe and effective, it can cause side effects in some people. The most common is a change in your periods, you may notice they become:
- lighter
- less regular with spotting between periods
- heavier and more painful
- last longer
- stop completely
Other very common implant side effects include:
- acne
- headache
- weight gain
- breast tenderness and pain
- irregular bleeding
- vaginal infection
A full list of side effects are printed in the Nexplanon patient information leaflet.
As well as potential side effects, the contraceptive implant may increase the risk of:
- an infection at the site where the implant is fitted
- the implant moving out of place
- high blood pressure
- a blood clot
- ectopic pregnancy (in rare cases where the implant fails)
The contraceptive implant and breastfeeding
The Nexplanon implant can be used while you are breastfeeding. Although a small amount of progesterone will pass into your breast milk, neither the production nor quality is affected. It also does not affect the growth and development of your child.
Benefits of the contraceptive implant
The contraceptive implant offers several benefits:
| Convenience and ease of use | ✓ Once inserted, the implant provides continuous protection for 3 years.
✓ No ongoing maintenance required or the need to remember daily pills or weekly patches. |
|---|---|
| Long-term protection | ✓ Protects against pregnancy for 3 years. |
| Highly effective | ✓ More than 99% effective at preventing pregnancy.
✓ Comparable to the combined pill. |
| Helps regulate periods | ✓ Period changes are a common side effect of the implant and results in lighter, less regular, or no periods.
✓ 20% of people who use the implant will not get periods. |
| Does not interrupt sex | ✓ Unlike barrier methods, like condoms, diaphragms, and caps, the implant doesn’t interrupt sex. |
| Rapid return to previous fertility | ✓ Your fertility status will return to what it was before the implant was fitted almost straight away following removal.
✓ It is possible to get pregnant as early as a week after removal of the contraceptive implant. |
Comparing the implant to other contraceptive methods
If you’re not sure if the contraceptive implant is the best method of contraception, the table below shows how it compares to other popular birth control options, including the pill, patch, and intrauterine system (IUS).
| Implant | Mini pill | Combined pill | IUS | Patch | |
|---|---|---|---|---|---|
| How it works | Small, flexible plastic tube that’s medically fitted under the skin in your arm and steadily releases progesterone to stop ovulation, thicken cervical mucus, and thin the womb lining. | Only contains progesterone and thickens the cervical mucus, thins the womb lining, and, in some cases, stops ovulation to prevent pregnancy. | Contains a combination of oestrogen and progesterone to stop ovulation, thicken cervical mucus, and thin the womb lining to prevent pregnancy. | Steadily releases progesterone into the bloodstream to prevent pregnancy similarly to the mini pill. | Similar to the combined pill, but releases oestrogen and progesterone into the bloodstream via the skin. |
| How often it’s taken or changed | Every 3 years | Daily | Daily | Every 3 to 8 years | Once weekly |
| Effectiveness – Perfect use | >99% | >99% | >99% | >99% | >99% |
| Effectiveness – Typical use | >99% | 91% | 91% | >99% | 91% |
| Key points | Good alternative if you cannot tolerate oestrogen or struggle to remember a daily pill. | Suitable alternative if you cannot tolerate or choose not to take oestrogen.
The mini pill does not interfere with sex. |
Highly effective with perfect use and doesn’t interfere with sex.
Also available in lower doses of oestrogen to lower the chance of side effects. |
Available as a non-hormonal copper intrauterine device (IUD).
Safe to use during breastfeeding. |
Suitable alternative to the combined pill.
Stays in place during showering, swimming, and exercising. |
| Application | Fitted by a healthcare professional | Self-administered | Self-administered | Fitted by a healthcare professional | Applied yourself at home |
There are many different types of contraception available, including hormonal, non-hormonal, and natural methods.
How to get the contraceptive implant
You can get the contraceptive implant fitted at:
- a sexual health clinic
- your GP surgery
- private clinics
If you are looking for a convenient alternative to the implant, at Superdrug Online Doctor we can provide the mini pill.
Is the contraceptive implant available on the NHS?
Yes, the contraceptive implant is available on the NHS, but you should ring your GP surgery to find out if it is available at your clinic before making an appointment. Otherwise, you’ll need to visit a sexual health clinic to get it fitted.
Conclusion
The contraceptive implant is a convenient, long-acting, reversible method of contraception that has many benefits. It’s fitted by a healthcare professional, and once it is in place, it will protect you from pregnancy for 3 years. This means you do not have to do anything extra during that time.
Compared to other methods like the pill or patch, the implant does not require you to perform any particular actions or remember to take or replace it. The implant also does not interrupt sex like barrier methods, such as condoms, do. You can also remove it at any time, and your fertility will return to normal quickly.
However, the contraceptive implant is not suitable for everyone. You can start a contraceptive pill consultation with one of our doctors now to explore some common options.
FAQs
When can I shower after getting the contraceptive implant?
You can usually shower 24 hours after you have had the contraceptive implant fitted with the dressing on. The dressing will dry naturally after bathing or showering and will remain effective.
Can the contraceptive implant cause weight gain?
The contraceptive implant is not directly linked with causing significant weight gain, but some people do report changes in weight when using it. Although it is listed as a potential side effect, research has found no evidence from short-term implant use. Many factors can contribute to an increase in weight, including fluid retention, diet, exercise, and underlying health conditions.
Why is my contraceptive implant hurting?
Pain around a contraceptive implant site can be caused by several factors, including a minor reaction to the insertion, an infection, or the implant moving out of place. If you are getting serious pain or it lasts for more than a few days, or it is accompanied by swelling, bleeding, or pus, you should contact your doctor or sexual health clinic for further advice.
Can you drink alcohol after getting the contraceptive implant?
Yes, you can drink alcohol after getting the contraceptive implant because there are no known interactions between alcohol and the implant. However, the effects of alcohol may be mistaken for or worsen the implant’s side effects, such as headaches and feeling sick.
How do you know if your implant is broken?
If you think the contraceptive implant is broken, you should contact your doctor straight away. Signs that the implant may be broken include:
- not being able to feel it
- it feels bent or misshapen or broken
- you’re getting pain, redness, swelling, or pus around the insertion site
Can the contraceptive implant move in my arm?
Yes, although it’s rare, the contraceptive implant can move from the place it was originally inserted. It usually only moves a few centimetres, but in rare cases it can move further. If you think the implant has moved out of place, contact your doctor so they can check it. If it has moved too much, you’ll need to have it removed and replaced.
What happens if I leave the implant in my arm for too long?
If you leave the implant in for longer than you are supposed to, its effectiveness will be reduced, increasing your risk of pregnancy. The implant is designed to be effective for 3 years. Your doctor or nurse will tell you when you’ll need to get it replaced on the day it is fitted.
Sources
- Association of Progestin Contraceptive Implant and Weight Gain, American College of Obstetricians and Gynecologists [28 May 2025]
- Contraceptive implant, NHS Inform [accessed 28 May 2025]
- How well contraception works at preventing pregnancy, NHS [accessed 28 May 2025]
- Implant fitting and removal, NHS [accessed 28 May 2025]
- Nexplanon 68 mg implant for subdermal use, emc [accessed 28 May 2025]
- Side effects and risks of the contraceptive implant, NHS [accessed 29 May 2025]
- What is the contraceptive patch?, NHS [accessed 28 May 2025]