Getting the contraceptive implant starts with a short appointment at a clinic or doctor’s office, where a trained provider inserts a small, flexible rod just under the skin of your upper arm. The whole insertion takes about a minute, and you walk out with pregnancy protection that lasts up to five years. Here’s what the process looks like from start to finish.
Where to Get It
The implant can be placed by doctors, nurse practitioners, and physician assistants who have been trained and certified in the insertion procedure. Not every clinic or provider offers it, so you may need to call ahead. Family planning clinics, OB-GYN offices, college health centers, and community health centers are the most common places to get one. When you schedule, ask specifically whether the provider is trained in implant insertion, since some primary care offices don’t offer it on-site.
What Happens at Your Appointment
The implant goes into your non-dominant arm (your left arm if you’re right-handed). Your provider will position it on the inner side of your upper arm, overlying the muscle about 3 to 4 inches above the elbow. They’ll clean the area and inject a small amount of local anesthetic to numb the skin. You’ll feel a brief pinch from the numbing shot, but the insertion itself is typically painless.
The implant comes preloaded in a special applicator that slides the rod just beneath the skin in one quick motion. There’s no incision and no stitches. Your provider will feel the area to confirm the rod is in place, then cover it with a small bandage and a pressure wrap. The whole procedure, from numbing to bandage, takes just a few minutes. You’ll want to keep the pressure bandage on for about 24 hours and the smaller bandage for a few days. Bruising and mild soreness around the site are normal and fade within a week or two.
When to Schedule It
Timing matters for how quickly the implant starts working. If you have it placed within the first five days of your period, it’s effective immediately. If you get it at any other point in your cycle, you’ll need to use condoms or avoid sex for seven days while the implant takes effect. Your provider can help you figure out the best timing based on your cycle or whether you’re switching from another method.
How Effective It Is
The implant is the most effective reversible contraceptive available. Its failure rate is 0.05%, meaning fewer than 1 in 1,000 women using it will become pregnant in a year. For comparison, the pill has a typical-use failure rate of 9% (mostly from missed doses), the copper IUD fails about 0.8% of the time, and the hormonal IUD about 0.2%. Because the implant requires nothing from you after insertion, there’s no gap between “perfect use” and “typical use.” It works just as well in real life as it does in clinical trials.
How Long It Lasts
The implant was originally approved for three years of use. The FDA has since reviewed data extending that to five years, based on a study of nearly 500 women who kept their implants past the three-year mark. During years four and five, there were zero pregnancies among the study participants. So depending on when your implant was placed and which guidance your provider follows, you may be able to keep it for up to five years before it needs replacing.
Cost and Insurance Coverage
Without insurance, the implant and insertion together typically cost between $400 and $800. Removal later runs $100 to $300. Under the Affordable Care Act, most private insurance plans are required to cover FDA-approved contraceptives, including the implant, with no out-of-pocket cost. Medicaid also covers it in all states. If you’re uninsured, Title X-funded clinics (like many Planned Parenthood locations) offer implants on a sliding fee scale based on income.
Changes in Bleeding Patterns
The most common side effect is a change in your period, and it’s also the most common reason people have the implant removed early. There’s no single “typical” experience. In the first few months, anywhere from a small percentage to roughly two-thirds of users have prolonged or irregular bleeding, while others stop getting periods entirely. By one year, about a quarter of users have no periods at all, about 30% have lighter or less frequent bleeding, and a smaller group still deals with extended spotting. After two years, the majority of users (53% to 77%) experience either no bleeding or infrequent bleeding. The pattern tends to improve over time, but it’s unpredictable in the early months.
Who Shouldn’t Get It
Most people are good candidates, but there are a few medical situations where the implant isn’t recommended. These include a current or past blood clot, active liver disease or liver tumors, a history of breast cancer or other hormone-sensitive cancers, and unexplained vaginal bleeding that hasn’t been evaluated.
Certain medications can also make the implant less effective by speeding up how quickly your body breaks down the hormone. These include some seizure medications (like carbamazepine, phenytoin, and topiramate), the antibiotic rifampin, and the herbal supplement St. John’s wort. Some HIV medications can also interfere. If you take any of these regularly, your provider will likely recommend a different contraceptive method.
Removal and Fertility After
Removal is another quick office visit. Your provider numbs the area, makes a tiny incision at one end of the rod, and slides it out. It takes a few minutes. If you want to continue using the implant, a new one can be placed through the same small opening.
Fertility returns quickly. Your body clears the hormone within days, and ovulation can resume within weeks. A systematic review of studies found that about 75% of former implant users who tried to conceive became pregnant within 12 months, a rate comparable to women stopping other hormonal methods. There’s no evidence that using the implant, even for several years, causes any long-term delay in fertility.