Nexplanon: what to know about the contraceptive implant

It prevents pregnancy mainly by stopping ovulation and also thickens cervical mucus, making it harder for sperm to reach an egg. A trained clinician inserts and removes it during a minor procedure.

Bleeding patterns can change after insertion. Periods may become irregular, lighter, heavier, longer, or stop; the pattern can also change over time. Other possible effects include headache, acne, breast tenderness, or mood changes. These symptoms have several possible causes, so persistent or troubling changes deserve a clinical review.

The implant does not protect against sexually transmitted infections. Condoms can reduce infection risk and may be used alongside it. Medicines and herbal products can sometimes reduce hormonal contraceptive effectiveness, so mention everything you take to the prescribing clinician or pharmacist.

Before placement, tell the clinician about unexplained vaginal bleeding, liver problems, breast cancer, allergies, pregnancy concerns, and all medicines or supplements. They will discuss whether backup contraception is needed based on when the implant is inserted and what contraception you were using beforehand.

After insertion, follow the wound-care instructions and check that you can feel the rod once tenderness settles. Do not try to move or remove it yourself. Arrange a review if you cannot feel it, its shape seems different, it appears to have moved, or side effects are difficult to manage.

Seek prompt medical advice for increasing redness, warmth, swelling, discharge, or pain at the insertion site; very heavy vaginal bleeding; new severe headaches; yellowing of the skin or eyes; or a suspected pregnancy. Get urgent help for chest pain, sudden breathlessness, coughing blood, collapse, or swelling and pain in one leg.

Ask when contraceptive protection begins in your situation, whether you need temporary backup contraception, how to look after the insertion site, and which bleeding changes should trigger review. Also confirm whether any current medicine interacts with etonogestrel and when the implant should be replaced or removed.