The birth control implant (Nexplanon) is a highly effective, long-acting reversible contraception (LARC). This small, matchstick-sized plastic rod is inserted just under the skin in the inner upper arm. It prevents pregnancy for up to three years by steadily releasing the hormone progestin, which inhibits ovulation and thickens cervical mucus. Many people considering this method are concerned about the pain involved, which includes sensations during the procedure, short-term recovery, and potential hormonal side effects.
Sensation During Insertion
The insertion procedure is quick, usually lasting only a minute or two after preparation. To ensure comfort, the healthcare provider first numbs a small area of the inner upper arm using a local anesthetic, such as lidocaine. The initial injection of this numbing medication is the most commonly reported sensation of pain, feeling like a sharp pinch or sting. Once the anesthetic takes effect, the provider uses a specialized applicator to place the implant just beneath the skin. During this brief step, you should not feel sharp pain, but rather a sensation of pressure or slight tugging as the rod is positioned.
Managing Localized Post-Procedure Soreness
After the local anesthetic wears off, typically a few hours after the procedure, localized soreness at the insertion site is common. This temporary discomfort results from the minor tissue manipulation required to place the implant. The area may develop bruising, swelling, and tenderness, often feeling like a dull ache. To manage this, the provider applies a pressure bandage, which should be kept on for about 24 hours to reduce swelling and bruising. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can alleviate the soreness. Bruising can persist for up to two weeks; avoid heavy lifting or strenuous arm activity for a few days to promote healing.
Hormonal Side Effects Causing Discomfort
Beyond temporary procedural soreness, some people experience discomfort related to the systemic effects of the progestin hormone released by the implant. These side effects differ from localized pain at the insertion site and can manifest in various ways.
Common Hormonal Discomfort
- Headaches, which can often be managed with standard pain medication.
- Breast tenderness or soreness due to hormonal changes.
- Abdominal cramping or pelvic pain, often related to changes in menstrual bleeding patterns, such as spotting or irregular periods.
- Back pain and muscle aches.
These symptoms are usually mild and tend to improve or subside completely within the first few months as the body adjusts to the steady dose of progestin. If systemic discomfort persists or becomes severe, it is important to discuss these symptoms with a healthcare professional.
What to Expect During Removal
Implant removal is a quick, in-office procedure similar to insertion. A local anesthetic is injected to numb the area, and the initial sting of this shot is typically the only acute pain felt. Once numb, the provider makes a small incision (less than an eighth of an inch) at the end of the implant. The implant is then gently retrieved using small forceps. During retrieval, you may feel tugging or pressure, but not sharp pain. Removal can be slightly more involved if scar tissue has formed around the rod, requiring extra manipulation and potentially leading to increased localized soreness. Following removal, a pressure bandage is applied, and the arm may be tender and bruised for a few days, similar to the insertion recovery.