I want to go on birth control and my friend said I should get the implant. What are some of the downsides to it?

Great question! There are a lot of different birth control options, so it’s great to look into them before making a decision. Every body is different so what’s best for your friend may not be what’s best for you.

What is the implant?

Nexplanon (also called the implant) is a tiny plastic rod that’s inserted under the skin in your upper arm in a quick 15 minute visit with your doctor. It prevents pregnancy by slowly releasing the hormone progestin, which stops your ovaries from releasing an egg. It also thickens your cervical mucus, making it more difficult for sperm to get to an egg in the first place. The implant works for up to 4 years, so once it’s inserted you don’t have to think about it for a long time! Just mark your calendar to remind yourself to get it replaced.

Like most “set it and forget it” birth control methods (sometimes called Long Acting Reversible Contraceptives, or LARCs), the implant is extremely effective at preventing pregnancy—over 99% effective! Unlike some other birth control methods, like the pill or condoms, there’s almost no room for human error.

It also doesn’t contain estrogen, which means people who can’t take estrogen can use the implant safely.

What are the side effects?

With any medication there will always be a chance of negative side effects. Most of the time the side effects go away within a few months, but if they’re severe it’s always best to talk to your healthcare provider.

The most common side effect (like with many birth control methods) is irregular bleeding, or spotting. Some people have heavier periods for the first 6-12 months on the implant. After that though, many people have much lighter periods, or even stop getting their period altogether! Some people like never having to see their Aunt Flow again, but others appreciate the monthly confirmation that they’re not pregnant. It’s totally safe to not get your period, but it’s a personal preference whether you want a break from getting your period or not. You also aren’t guaranteed to not have a period. The truth is you just won’t know how your body will react until you try it.

It’s also common for your arm to feel sore after the implant is inserted, but this usually goes away after a few days. Some people are worried about insertion being painful, but your doctor will give you a shot to numb the area. You may feel a pinch and some pressure, but it shouldn’t be painful.

Other side effects that are not as common include headaches, nausea, breast pain, acne and mood swings. Again, since every body is different, you may get all or none of these symptoms.

What else should I know?

The implant might be the perfect form of birth control for you right now—or it might not be! There are lots of great methods out there. We talk more about how to decide on a birth control method here, but you should also talk to your doctor. Sometimes, it takes a few tries to find a method that works with your body and your lifestyle. That’s completely normal!

Getting the implant removed takes only a few minutes longer than getting it inserted. You can get pregnant as soon as it’s removed. That’s great if you decide you’re ready to have a baby, but if you still don’t want to become pregnant make sure you use another method of birth control as soon as the implant is taken out.

Keep in mind that the implant does NOT prevent the spread of sexually transmitted infections (STIs). The only birth control method that does that is condoms. Be sure to use condoms the right way, every time you have penis-in-vagina (PIV) sex (and oral sex or anal sex), and to get regularly tested for STIs.

If you have any other questions about birth control, sexual health or your body, make an appointment at the Mount Sinai Adolescent Health Center. We provide confidential, comprehensive healthcare at no cost to patients to 10-26 year olds in NYC. No immigration restrictions, no insurance needed.

A version of this post was originally published in August, 2019.