In This Section
- Birth Control Implant
- How effective is the implant?
- How can I get the implant?
- What happens when the implant is inserted?
- How safe is the implant?
- What are the benefits of the implant?
- What are the disadvantages of the implant?
- What happens when the implant is removed?
Some people get side effects that bother them after getting their implant, but these usually go away after a few months. Rarely, the side effects can be serious.
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- The implant can have negative side effects.
- Birth control implants don’t protect against STDs.
- A strong study on hormonal birth control and depression
- Risk of depression with hormonal birth control, small but real
- *My medical researcher mind is boggled: all this information collected on every single citizen makes quality research studies like this easily possible. We can’t even dream of conducting such an inclusive study like this here in the United States, where yes, all these data are collected, but exist haphazardly scattered across medical offices, hospitals, and insurance companies. Most of a U.S. researcher’s funding and efforts here go into collecting subjects and data. Compared to what the Danish have, what a waste of time!
- What it’s like to get the crazy futuristic birth control that’s implanted into your arm
- The insertion can be painful — but it’s fast.
- You may have unpleasant side effects.
- The women INSIDER spoke with had varied side effects.
- The implant has another major plus: You can feel it under the skin.
- Some people should not use the implant.
- The women INSIDER interviewed gave mixed reviews of their overall implant experience.
- “If you’re unhappy with the hormonal contraceptive you are taking—ask about other options”
- “Talking with my doctor helped open my eyes about birth control options I had dismissed”
- “My insurance was running out and I didn’t want to risk not having birth control”
- “It went in easily, has caused no pain, and has even lightened my periods”
- “I did not connect the depression with the device until I had the implant removed”
- “Maybe my body just rejects synthetic hormones”
- “Because I have epilepsy, I need to be careful about my birth control methods”
- “My mum suggested it”
- “Listen to your body. If something doesn’t feel right, speak up”
- “I like having the extra backup on the contraceptive side of things”
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The implant can have negative side effects.
Some people have side effects after getting Nexplanon, but many adjust to the implant with few or no problems at all. Negative side effects usually go away after a few months, once your body gets used to your implant. You can use our birth control app to keep track of the side effects you are experiencing.
The most common side effect is irregular bleeding (aka spotting), especially in the first 6-12 months. Sometimes the implant causes long-term spotting, or periods get longer and heavier. But for most people, the implant makes their periods way lighter — 1 in 3 people with the implant stop getting their periods at all after a year.
It’s totally safe to not get a period while you’re on Nexplanon. And you don’t need to worry about being pregnant even if you don’t get a period, because the implant is really, really effective birth control. (You can always take a pregnancy test if you want to be sure.)
Other possible side effects that aren’t as common include:
Pain or bruising where the implant was inserted
An infection where the implant was inserted
Birth control implants don’t protect against STDs.
Birth control implants are one of the best methods of birth control out there, but they don’t protect you from sexually transmitted infections. Luckily, using condoms every time you have sex really reduces your chances of getting or spreading STDs. So using condoms + Nexplanon is the best way to protect yourself from pregnancy and STDs.
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Over the years, more than a few patients in my women’s health practice have told me that their hormonal birth control — the pill, patch, ring, implant, injection, or IUD — made them feel depressed. And it’s not just my patients: several of my friends have felt the same way. And it’s not just me who has noticed this; decades of reports of mood changes associated with these hormone medications have spurred multiple research studies.
While many of these did not show a definitive association, a critical review of this literature revealed that all of it has been of poor quality, relying on iffy methods like self-reporting, recall, and insufficient numbers of subjects. The authors concluded that it was impossible to draw any firm conclusions from the research on this birth control and depression.
A strong study on hormonal birth control and depression
However, another does meet the criteria to qualify as high-quality, and therefore believable. The study of over a million Danish women over age 14, using hard data like diagnosis codes and prescription records, strongly suggests that there is an increased risk of depression associated with all types of hormonal contraception.
The authors took advantage of Denmark’s awesome nationalized information collection systems, including diagnosis and prescribing data. These exist because the country has had a well-run and organized national health system for decades. They have reams of data on every single person in Denmark going back to the 1970s. Additional available information used in this study included education level, body mass index, and smoking habits. All of this was de-identified to protect the individuals involved, so there was no potential violation of privacy.* Surprising connections between hormonal birth control and depression emerged.
This study looked at women aged 15 to 34 between 2000 and 2013, and excluded those with preexisting psychiatric conditions, as well as those who could not be prescribed hormones due to medical issues like blood clots, and those who would be prescribed these medications for other reasons. They also excluded women during pregnancy and for six months after pregnancy, and recent immigrants. This way they wouldn’t accidentally include women with an unrecorded history of any of these conditions.
The researchers analyzed hormonal contraceptive use and subsequent depression in two different ways. They evaluated women who had received a diagnosis of depression as well as women who had received a prescription for antidepressants; these analyses were run separately, and they obtained statistically equivalent results.
Risk of depression with hormonal birth control, small but real
All forms of hormonal contraception were associated with an increased risk of developing depression, with higher risks associated with the progesterone-only forms, including the IUD. This risk was higher in teens ages 15 to 19, and especially for non-oral forms of birth control such as the ring, patch and IUD. That the IUD was particularly associated with depression in all age groups is especially significant, because traditionally, physicians have been taught that the IUD only acts locally and has no effects on the rest of the body. Clearly, this is not accurate.
Should we stop prescribing hormonal birth control? No. It’s important to note that while the risk of depression among women using hormonal forms of birth control was clearly increased, the overall number of women affected was small. Approximately 2.2 out of 100 women who used hormonal birth control developed depression, compared to 1.7 out of 100 who did not. This indicates that only some people will be susceptible to this side effect. Which ones, we don’t know. But I plan to discuss this possibility with every patient when I’m counseling them about birth control, just as I would counsel about increased risk of blood clots and, for certain women, breast cancer. In the end, every medication has potential risks and benefits. As doctors, we need to be aware of these so we can counsel effectively.
What it’s like to get the crazy futuristic birth control that’s implanted into your arm
“The initial studies that were done to validate the implant only tested it for three years,” Pesci told INSIDER. “But we have plenty of data now — well designed studies with large numbers of patients — that have found that it’s completely reliable beyond three years.”
But if you want to get pregnant (or you just don’t like it), a doctor can easily remove the implant at any time.
The insertion can be painful — but it’s fast.
A woman in the Philippines receives a birth control implant. Reuters/Erik de Castro
The implant is placed subdermally — under the skin — in a quick procedure at the doctor’s office.
“The doctor numbed my arm, they used this small tool to slit my skin and slide the implant in,” Celine, a 24-year-old woman, who’s had the implant for 11 months, told INSIDER. ” said a lot of patients faint during insertion, and she asked me about 10 times if I was okay. took probably two minutes in total.” She also said it left a small scar.
Unfortunately it’s hard to say exactly how painful the insertion is (or if you’ll faint). Accounts of the experience vary from person to person.
“On a scale of one to 10, the pain was a seven, but it was a stab that lasted for a few seconds,” Lauren, a 23-year-old who had the implant for about 20 months, told INSIDER.
You may have unpleasant side effects.
Weight gain is a possible side effect of the implant. Sophia Charlotte / Flickr
The most common side effect of the implant is a change in your monthly bleeding pattern. You might get irregular bleeding or spotting, and your period can get longer, shorter, or disappear altogether. about 1 in 10 women stop using the implant because of changes like these.
There is a chance that there will be complications with the insertion. Other common side effects are mood swings, weight gain, headache, acne, and a depressed mood.
This is another way that the implant differs from the IUD. In hormonal IUDs, the hormone acts locally, right inside the uterus, and very little of it gets into your bloodstream. That’s not so with the implant.
“The implant is placed subdermally and the hormone then has to travel through the bloodstream in order to reach its target organ, which is the uterus,” Pesci explained. “As it courses through the body it has the ability to affect other organs and other systems on its way. That’s why it can affect the skin, it can affect metabolism, things like that.”
The women INSIDER spoke with had varied side effects.
The 27-year-old teacher, for instance, said she couldn’t confidently attribute any side effects to the implant itself.
“Like many birth controls, there was a weight gain warning,” she said. “I have gained weight, but I’ve also gotten older and my lifestyle is different.”
“I have only had my period once in almost a full year,” Celine said. “There were also noticeable changes in my sex drive for the first 3 months or so, but then everything leveled out.”
“Side effects I experienced included a 15-pound weight gain, extreme sensitivity, easy fluctuations of mood, general fatigue, and light or no periods,” Lauren said. “Other than my unpleasant weight gain, I was crying a lot. I’m a sensitive person to begin with, but a lot of things that I didn’t know I really cared about, got me quite worked up
On the plus side, I barely ever got periods, and if I did, it was extremely light.” (She decided to have her implant removed after almost two years.)
But remember that not everyone will have a negative experience with the implant. And for some women, Pesci said, the assurance of really effective contraception is worth potential side effects.
The implant has another major plus: You can feel it under the skin.
The implant is almost impossible to notice just by looking, but it’s easy to feel. With the implant, Pesci said, “women have this long-acting method that they can touch. They can feel it every single day and they know that it’s there and that they’re protected. It’s comforting to a lot of women.”
IUDs, by contrast, are harder to feel — you’ve got to learn how to reach up to the cervix and feel the strings, and you might worry about whether it’s moved out of place.
Some people should not use the implant.
“If a woman values having a period and having a regular period, that’s the only person that I would probably counsel away from the implant,” Pesci said. “Because we can’t tell her with 100% certainty that she will have a period or a predictable period.”
Women who have liver disease, liver tumors, hormone-responsive breast cancer or a history of blood clots also shouldn’t use the device.
The women INSIDER interviewed gave mixed reviews of their overall implant experience.
“It makes your life so easy,” the 27-year-old teacher said. “No more pain from periods or money spent on feminine hygiene products! I think it’s easy to see if you want kids in the next 3 years or not, so this is a perfect longer term solution.” She plans to get a new implant once her current one expires later this year.
Lauren — the woman who experienced weight gain and mood swings after getting the implant — said she’d still recommend it, as long as women are aware of the possible side effects from the get go.
Celine said she’d recommend the implant only if an IUD wasn’t an option. “I’ve toyed with getting the implant removed multiple times, especially in the first few months,” she said.
The bottom line: Always talk with your doctor about what birth control method is best in the context of your overall health. The implant might turn out to be your perfect fit, and it might not. The good news is that there are plenty approved contraceptives to choose from. Here’s a helpful guide to narrowing down the options.
There are so many types of birth control and it can be hard to know which one is right for you. People have a huge variety of experiences with the contraceptive implant. We reached out for personal stories—here’s what you had to say.
“If you’re unhappy with the hormonal contraceptive you are taking—ask about other options”
I got my first Nexplanon implant in 2012, and had it removed in 2015. I then had a second one of the same brand put in in 2015-2016. I decided to get an implant because I was already limited due to not being able to take estrogen, and had tried the progestin-only pill as well as the injection.
The pill gave me irregular bleeding, sometimes constant bleeding, for months on end, as well as severe nausea. After a year or so I knew I had to look for another contraception method. I had a similar reaction to the progestin injection, minus the nausea, and as I was only a teenager at the time, I found it difficult to remember when I needed to get another injection (which resulted in many a post-coital panic). I was only offered the implant after expressing to my doctor that I did not want to take the pill.
The insertion was completely pain free (apart from the pin prick of anaesthetic). I felt a slight tugging when they are putting it in but no pain. My arm ached for the next few days, and I wasn’t able to do any heavy lifting with it, and there was some bruising and tenderness but nothing serious. I experienced some irregular bleeding for the first three-ish months, but it seemed to sort itself out and went from a light monthly period to 100% period free for two years.
During the last year of my first implant I did start having regular monthly periods again, and when I had my new one inserted I experienced the same irregular bleeding as before for the first few months. Side effects wise, I did find my sex drive lowered (this happens to me when I take any hormonal contraceptive) and experienced vaginal dryness (thank god for lube) however it didn’t negatively impact my love/sex life at all.
I had my second implant removed as I had been on hormonal contraception since around the age of 15 and wanted to get to know my body without the additional hormones. I went completely hormone-free for about a year, using only barrier methods, but quickly got tired of their unreliability. I decided to get the copper IUD which is still hormone free, however I am thinking about getting it removed in favor of the implant, as it has made my period cramps almost unbearable.
If you’re unhappy with any hormonal contraceptive you are taking, always tell your doctor. Do not back down if they try to offer you more of the same, and ask about other options—because they are there!
—Grace, female, 22, England
“Talking with my doctor helped open my eyes about birth control options I had dismissed”
I got an Implanon implant inserted in September 2017, and have had it for over a year now. I wanted to have sex with my significant other without worrying about getting pregnant. I also hoped it would help reduce the frequency of my periods and my acne. Getting the implant inserted was a simple and quick process. I had a large bruise in the area for a few days, but no other discomfort since then. The first few months with the implant left my cycle significantly altered and unpredictable, but keeping track of it with Clue helped me a lot. My acne and frequency of bleeding are still all over the board, but I am a firm believer that this is the best birth control choice for me, and I will continue to use it for the next several years.
Your doctor should go over all of the different birth control options and side effects before you receive any type of birth control. Doing so helped open my eyes about other birth control options I had dismissed. Also, practicing healthy sex is extremely important! Just because you are on birth control does not mean you shouldn’t use a condom when you’re with someone new or don’t know the sexual history of a partner. Better safe than sorry!
—Bonk, nonbinary, 19, Minnesota, USA
“My insurance was running out and I didn’t want to risk not having birth control”
I got the Nexplanon implant in October of 2016. I was 25 and had it in for around a year and a half. At the time, my insurance through my parents was running out and I didn’t have a full-time job. I didn’t want to risk not having birth control if I didn’t get a full time job, so I got the implant to be on the safe side. Not because I wanted to. I loved the pill I was on.
Getting it in wasn’t bad because the area was numbed, but there was pain in my arm afterwards, which lasted for a few days—like someone punched me really hard in the arm. There weren’t any mood swings, but there was HORRIBLE acne. I always had almost perfect skin before, then I started to break out every other day, and nothing cleared it up. My period was completely irregular too. I would bleed for three to four months straight, then not get a period for three months, and then it would be back for months again. It was horrible. My period was light most months, but I use a cup exclusively so things got sore inserting a cup every day for months on a light flow. I had to switch back to pads/liners, and I hated using them again.
I decided to have my implant removed because I could not deal with the side effects. I went from a great birth control, Jolessa, to the Nexplanon and hated it. My skin had never looked so bad and I gained a lot of weight in the year I was on it. It was not worth the hassle. When my insurance with my new job kicked in, and I could get in to see my gyno, I switched back to my pill. After 4-6 months, my skin cleared back up and I lost 10 pounds. For me the implant was not worth all the side effects. I hated being on it.
—Erica S, 27, female, New York, USA
“It went in easily, has caused no pain, and has even lightened my periods”
I got the Nexplanon implant 2 years ago. I was in a long-term relationship that was getting physical and I wanted birth control that didn’t require me to remember to take a pill. My experience has been great! It went in easily, has caused no pain, and has even lightened my periods. It has made period cramps worse, but nothing Midol can’t handle.
—Anonymous, female, 36, Washington State, USA
“I did not connect the depression with the device until I had the implant removed”
I got an Implanon four years ago, and had it removed a year ago. The reason I got one is because I was anemic and my doctor recommended it to reduce heavy periods. Insertion was easy. At first it made my periods impossible to track, then it settled down. My periods became lighter but this might also be because of my age (mid 40s) I put on quite a bit of weight and experienced depression which struck especially just after my period, and went away as soon as I had the device removed. I did not connect the depression with the device until I had the implant removed and experienced a dramatic change in my moods.
I had my implant removed because they wear out after 3 years. I have not replaced it with a different kind. My advice would be: Track your moods carefully. Keep a mood diary. If you notice you are getting depressed and anxious, find a doctor who will listen to you and believe you. My implant definitely made me depressed in a way I had not experienced before.
Implanon is easy to put in, and difficult and painful to take out. The doctor had to dig in my arm for ages. Doctors also didn’t want to believe me when I told them my hormonal contraceptive was affecting my mental health.
—Masha, female, 46, Cape Town, South Africa
“Maybe my body just rejects synthetic hormones”
I got an implant in 2010, for about 6 months—to reduce heavy bleeds and for the added contraceptive value. Before I got it, my GP at the time was hesitant because she was concerned that the implant would exasperate my depression—she was ABSOLUTELY right. Of course, the implant wasn’t the only factor but within three months of getting the implant, I had made two suicide attempts. I had never attempted suicide before. During recovery from the suicide attempts, I tried to eliminate various things from my life to help pinpoint the problem, the implant was the last step and I did get better. Again, it definitely wasn’t the only factor—I was in therapy at this point and making life changes that all contributed to my recovery, but I think the implant played a part.
I never had any improvement with bleeding. I bled for 30 days straight when I first got it and then continued to bleed irregularly until I got it taken out. I get really bad side effects from the combined pill, the mini pill and norethisterone, so maybe my body just rejects synthetic hormones. My sister got the implant after her third child and seemed to be happy with it. Having it inserted wasn’t an issue. Having it removed was a little more unpleasant, and I have a tiny scar only I can notice, but overall it wasn’t an issue.
I would advise that anyone with PCOS and/or depression/anxiety, does some research and has a thorough talk with their doctor before going for it. Technically, you can have it taken out whenever, but getting rid of it is less convenient than simply not taking a pill.
—Adjoa, cis woman, 27, Ghana/UK
“Because I have epilepsy, I need to be careful about my birth control methods”
I got the Nexplanon implant in August of 2016. Before I got Nexplanon, I tried the Mirena (IUD). I had that for about a year or so until I started experiencing cramping every single day. It was just as bad, if not worse, than my menstruation cramps. Nothing was wrong with the IUD, its placement, nor did I have any cysts; my body just didn’t like the IUD in it after a year.
Because I have epilepsy, I need to be careful about my birth control methods. I didn’t want to do depo (Depo-Provera) shots since that would require regular visits to a doctor that I wouldn’t be able to afford. I chose Nexplanon for how long it lasted, and how it wouldn’t interact with my antiepileptic medication.
My experience with Nexplanon has been fantastic. Its insertion was relatively painless, especially compared to that of an IUD. It stopped my menstrual cycle (the bleeding, cramping, and whatnot), which I cannot be more happy about. During my menstrual cycle, not only is the cramping intense, but my mental illnesses and gender dysphoria get worse. After I had the Nexplanon put in, I experienced a lot less of that. Before I had it inserted, I was worried it would not work out for me just like the IUD, and that it would move. In the two years I’ve had it, I’ve experienced nothing but positive side-effects.
My options for contraception as an epileptic are limited. Out of all the forms of contraception I know of, it appears to be the best for me short of tubal ligation. The only reason I would have it removed is to have a child, or to get a new one put in.
My advice to others? Talk to your gynecologist about all of the options available to you, and why you want to use an implant. Ask about the side-effects, what could happen, and the cost with and without insurance.
—Anonymous, neutrois (trans/nonbinary), 28, Maine, USA
“My mum suggested it”
I got an Implanon implant when I was 16. My mum suggested it. I think it gave her peace of mind, and I was happy not to have to think about the pill. Getting it inserted was weird, but not that painful. It was a dream for the first year or so—no periods, no side effects that I noticed. But after a year or so i started getting three week long periods, and it got annoying so i got it removed.
—Gemma, female, 26, Newcastle, UK
“Listen to your body. If something doesn’t feel right, speak up”
I got the Nexplanon implant in 2015 and had it removed around nine or ten months later. The birth control pills I was taking triggered migraines, and the birth control shot had a lot of unpleasant side effects. Also, I loved the idea of not having a period each month.
The insertion process was simple, and I didn’t find it painful. Unfortunately, I experienced several unpleasant side effects. I would bleed for about three weeks of every month, I gained quite a bit of weight, and had extreme mood swings.
I had the implant removed because of all of the negative side effects I was experiencing. The removal process was more tricky in my case than the insertion. It had migrated, and my doctor had difficulty removing the implant.
The implant did not work for me, but I have friends who have the same implant and they love it. If you’re interested, go ahead and try it. But listen to your body. If something doesn’t feel right, speak up. I kept the implant in for far too long because I kept waiting for it work for me the way it was supposed to. I should have had it removed months earlier than I did.
—Morgan, female, 32, Springfield, Missouri USA
“I like having the extra backup on the contraceptive side of things”
I got a Nexplanon implant two years ago, mainly to stop having periods but I also moved in with my partner full time, so I decided to get some method of round-the-clock contraceptive too.
My experience has been fine. Insertion was very quick. The doctor talked me through what was happening. I had a small dose of localised anesthetic before hand, then she used what looked like a piercing gun to insert the implant (not as traumatic as it sounds) and I didn’t feel any pain. I kept it bandaged for a day or two afterwards. Now I have a small scar on the point of insertion, but I do scar easily. I had some light bleeding but no pain like I used to . After the insertion I didn’t have a period for about 8 months, then I bled lightly for about 3 days, then it stopped again for another 8 months.
I plan on sticking with the implant. For me, it has been useful in stopping periods, and I like having the extra backup on the contraceptive side of things.
—Anonymous, female, 20, Sheffield, UK
We at Clue recommend that you see a healthcare provider to discuss which birth control is best for you, and let them know if you are experiencing any negative side effects.
Read more about birth control.
to track your birth control and cycle symptoms.