Getting Nexplanon involves a short appointment with a trained healthcare provider who inserts the small, flexible rod into your upper arm. The process from first call to walking out with the implant can happen in a single visit, though some clinics prefer a separate consultation first. Here’s what to expect at each step.
Where to Go for Nexplanon
Nexplanon can only be placed by a healthcare provider who has completed the manufacturer’s training program. This includes many OB-GYNs, family medicine doctors, nurse practitioners, and physician assistants. Planned Parenthood clinics, community health centers, and most university health services offer the implant. Your regular primary care doctor may also be certified, so it’s worth calling their office first.
When you call to schedule, ask specifically whether the provider is trained to insert Nexplanon. Not every clinician at a given practice will be, and confirming ahead of time saves you a wasted appointment. If you don’t have a regular doctor, Planned Parenthood’s website and the manufacturer’s provider locator tool can help you find a nearby option.
What Happens Before Insertion
Your provider needs to confirm you’re not pregnant before placing the implant. This can be done with a pregnancy test or simply based on timing. A provider can be reasonably certain you’re not pregnant if you meet any of these criteria:
- You’re within 7 days of the start of your last period
- You haven’t had sex since your last period started
- You’ve been consistently using another reliable birth control method
- You’re within 7 days of a miscarriage or abortion
- You’re within 4 weeks postpartum
- You’re exclusively breastfeeding, haven’t gotten your period back, and are less than 6 months postpartum
No pelvic exam is required. Your provider will review your medical history and ask about any medications you take, since certain drugs can interact with the implant. Beyond that, the screening is straightforward.
Who Should Not Get Nexplanon
Nexplanon is safe for most people, but the FDA labeling lists several situations where it should not be used. These include known or suspected pregnancy, current or past breast cancer, unexplained vaginal bleeding that hasn’t been evaluated, liver tumors or severe liver disease, and allergy to any component of the implant. Your provider will go over your full medical history to rule these out during your visit.
Timing Your Insertion
When during your cycle you get the implant placed determines whether you need backup birth control afterward. If the implant goes in within the first 5 days of your period, it starts working immediately and no backup is needed. If it’s placed after day 5, you’ll need to use condoms or avoid sex for 7 days while the implant becomes effective.
If you’re switching from another hormonal method like the pill, ring, or patch, your provider can time the insertion so there’s no gap in protection. For people switching from an IUD, the implant is typically placed before the IUD is removed to maintain continuous coverage.
What the Insertion Feels Like
The entire insertion takes only a few minutes. Your provider will have you lie on your back with your non-dominant arm bent and positioned near your head. They’ll mark the insertion site on the inner side of your upper arm, then inject a local anesthetic to numb the area. You’ll feel the numbing shot (a brief sting), but the actual implant placement should be painless.
The implant is loaded into a special applicator that slides it just under the skin. Once it’s in, your provider will ask you to feel the rod with your fingers to confirm it’s positioned correctly. The whole process, from numbing to placement, typically takes under five minutes. There are no stitches.
Aftercare in the First Week
You’ll leave the office with two bandages: a pressure bandage wrapped around your arm and a smaller adhesive bandage directly over the insertion site. Remove the pressure bandage after 24 hours. Keep the adhesive bandage on for 3 to 5 days.
Bruising around the insertion site is normal and can look dramatic, sometimes spreading across a few inches of your upper arm. This fades within a week or two. Soreness at the site is also common for the first few days. You can take over-the-counter pain relievers and apply ice if needed. Avoid heavy lifting with that arm for a couple of days.
Side Effects to Expect
The most common side effect is changes to your bleeding pattern, especially in the first 6 to 12 months. Some people experience irregular spotting, lighter periods, longer periods, or no periods at all. There’s no way to predict which pattern you’ll get, and it can shift over time. For many people, bleeding becomes lighter or stops altogether after the first year.
Less common side effects include headaches, breast tenderness, nausea, weight gain, and ovarian cysts (which are usually harmless and resolve on their own). Pain or bruising at the insertion site and, rarely, infection at the site can also occur. Most negative side effects ease up within a few months as your body adjusts.
How Long Nexplanon Lasts
Nexplanon is now FDA-approved for up to 5 years of use, extended from the original 3-year approval. This makes it one of the longest-lasting reversible birth control options available. When the 5 years are up, you can have the old implant removed and a new one placed in the same visit if you want to continue.
The implant is also one of the most effective contraceptive methods. Clinical trials found a failure rate of 0.38 pregnancies per 100 women over 3 years, which translates to more than 99% effectiveness. Unlike the pill, there’s no daily action required, so the real-world effectiveness matches the clinical trial numbers closely.
Cost and Insurance Coverage
Under the Affordable Care Act, most insurance plans are required to cover all FDA-approved birth control methods with no out-of-pocket cost. That includes the implant itself and the insertion procedure. If your plan is ACA-compliant, you should pay $0.
Without insurance, the total cost for the implant and insertion ranges from roughly $400 to $2,300 depending on the clinic and region. Removal later costs between $0 and $300. Planned Parenthood and community health centers often offer sliding-scale fees based on income, and some state Medicaid programs cover the implant fully. If cost is a barrier, calling ahead to ask about payment options or financial assistance programs is a practical first step.