How to tell if a birth control implant is the right choice for you

The Pill, IUDs, implants … which birth control option is ‘best’ depends on each person’s body, lifestyle and goals. OB/GYN Matthew Scalise, Jr., MD, noted that one of his favorite options to discuss with patients is the birth control implant. He explained how birth control implants work and how to know if they’re the right choice for you.

Birth control implants compared to the Pill, IUDs and more

“There are a lot of different birth control options out there. Usually, the one people think of first is ‘the pill,’ which you take throughout the month as part of your daily routine,” said Dr. Scalise. “Birth control pills work by blocking conception using progestin, often in combination with estrogen. There’s also the IUD, a T-shaped implant that goes directly into the uterus and releases copper, a natural spermicide, to ensure no sperm is able to fertilize an egg.”

The birth control implant, on the other hand, is a thin plastic rod that goes into your arm. It works by releasing a hormone called etonogestrel, a type of progestin, and it doesn’t have estrogen, which makes it a good option for those who are worried about estrogen-based birth control due to family history of blood clots or other potential risk factors.

What makes the birth control implant effective?

“Nexplanon works mainly by stopping ovulation. You’re not releasing an egg each month, so there’s nothing for sperm to fertilize,” said Dr. Scalise.

The implant, which is placed along the inside of the arm, usually your non-dominant side, also thickens cervical mucus. This makes it harder to sperm to reach the egg and makes the lining of the uterus thinner. It’s hard for an embryo to implant when the uterine lining is thin.

The American College of Obstetricians and Gynecologists noted that fewer than 1 in 100 women will become pregnant while on the birth control implant, making it one of the most effective options out there.

Is it painful to get a birth control implant?

“Patients have told me the worst part of the process was actually receiving the numbing medication, which is injected into their arm before we put in the implant,” said Dr. Scalise. “It’s the same pinch you get when you receive a flu shot or give blood.”

After that, you may feel some pressure or slight discomfort, but there shouldn’t be any sharp pain. Some people do have some soreness or tenderness at the implantation site for a few days afterward.

In very, very rare cases, there may be some scarring, a tingling or numbing sensation or infection.

Are there side effects to the birth control implant?

“This is one of the most common questions about the birth control implant,” said Dr. Scalise. “I understand why. If you’ve struggled with side effects from other birth control options, it can leave you cautious when it comes to trying something new.”

The most common side effect of the birth control implant is a change in your menstrual pattern. Some people may have lighter periods or stop having them, while others might find menstrual bleeding becomes irregular or unpredictable. Dr. Scalise noted that in his experience, his patients have most commonly had their periods become lighter or stop altogether.

Because it doesn’t contain estrogen, the birth control implant avoids the estrogen-related side effects that have given the pill such a bad rap.

Can a birth control implant fall out?

“Technically, yes,” said Dr. Scalise. “An implant could come out if it was placed incorrectly, though I have yet to see this in my professional career thus far. If an issue were to arise, it would be if the implant were placed too deeply, making it difficult to feel and remove it when the time comes.”

Right after placement, you and your provider should both feel the implant in your arm.

Can you still get pregnant on the implant?

Pregnancy is possible with almost any birth control method, but the birth control implant is nearly 100% effective. Unlike taking a pill, replacing a patch or remembering to get an injection, the Nexplanon implant removes the risk of user error.

Is there anyone who should not receive birth control implants due to potential complications or risks?

“The birth control implant is safe for many patients, including adolescents, women who have never been pregnant and women with BMI greater than 40,” said Dr. Scalise. “Before you get the implant, your medical provider will review with you your medical history, current medications and any concerns that might affect whether or not it’s the right option for you.”

You shouldn’t receive the birth control implant if you’re pregnant or could be pregnant, have a history of blood clots or thromboembolic disease, have active liver disease or liver tumor, have unexpected abnormal uterine bleeding that hasn’t yet been evaluated, have current or prior breast cancer or other cancer that’s sensitive to progestin or if you are allergic to any component of the implant.

Low maintenance, highly effective, reversible birth control

“For many people looking for reliable birth control that’s reversible, effective and doesn’t take a lot of constant thought or planning on their part, the birth control implant is a great option,” said Dr. Scalise. “It removes that daily stress of remembering to take a pill and protects you against pregnancy without having to be something that’s constantly on your mind.”

Anyone interested in the birth control implant should speak with their gynecologist on whether it might be a good fit for you.