Nexplanon: A Guide for Teens and Parents

Nexplanon is one of several options available at Allegro Pediatrics for birth control or to help with painful periods. By understanding how it works, its benefits, and potential side effects, you can make an informed choice about whether it’s right for you.

What is Nexplanon?

LARC stands for Long-Acting Reversible Contraception, which includes intrauterine devices (IUDs) and the implant (Nexplanon®). Both LARC methods are 20 times more effective at preventing pregnancy than birth control pills, the patch, or ring.¹ They have been cited as working 99.2-99.95% of the time compared to 75-92% for the pill, depending on how well you remember to take it at the same time every day.² Both methods are safe for use in teenagers and adults, including individuals who have never been pregnant. At Allegro, we offer Nexplanon and have trained providers in both insertion and removal of the device.

How does Nexplanon work?

Nexplanon is a tiny birth control implant that prevents pregnancy by releasing a hormone called progestin into the body. It's a matchstick size, flexible rod that is inserted just under the skin in the upper arm. It is radiopaque, meaning that it can be seen on x-ray. Nexplanon helps prevent pregnancy by stopping ovulation, thickening the cervical mucus to make it harder for sperm to reach an egg, and thinning the lining of the uterus. It is FDA approved for 3 years,³ at which time it can be removed and reinserted for a new implant if desired. It may be inserted any time during the menstrual cycle. During the insertion, the provider will numb your arm prior to placement so it doesn’t hurt.

What are the possible side effects?

The most common side effects are changes in menstrual bleeding pattern, acne, headache, vaginal inflammation, weight gain (typically less than 5 pounds), breast pain, and abdominal pain.^3,4 An individual is not able to have Nexplanon placed if they are pregnant, have a history of blood clotting disorder, liver disease or personal history of breast or other progestin sensitive cancer. Rare side effects include ectopic pregnancy if one does become pregnant while using Nexplanon, blood clots and ovarian cysts.³ Rarely, the implant may move in the arm after insertion.

Vaginal Bleeding on Nexplanon

Nexplanon is often desired to induce amenorrhea, or a complete lack of vaginal bleeding. One in five individuals (about 20%) report amenorrhea in the first 2 years after placement, while 33% reported infrequent bleeding (less than 3 days of bleeding in 90 days). 23% reported prolonged or frequent bleeding.³ Providers are unable to predict which patients will experience a change in their menses prior to placement. The pattern of bleeding experienced after the first three months is likely to be the bleeding pattern an individual will experience over the next 2 years while the device remains implanted.

Continuation Rates

Nexplanon has a high rate of continuation, with one study finding that 82% of teens ages 14-19 continued using their device 12 months after placement. This rate is significantly higher than birth control pills in the same age group with a reported continuation rate of 47%. Irregular bleeding is the most common reason individuals stop using Nexplanon, while weight gain is cited by 2-7% of users as their reason for discontinuation.⁴

High Satisfaction Rates

Many teens who receive Nexplanon report high satisfaction rates. The same study that looked at continuation rates in teens found that 54% of those between 14-19 years old who received the Nexplanon rated their satisfaction as “very satisfied.” The patch had the lowest satisfaction rate with only 6% rating their experience as “highly satisfied.”⁵

Fertility after Nexplanon

Return to fertility is considered rapid after removal, as early as the week or two after removal.⁶ Normal menstrual cycles should return within 3 months after removal if another birth control method is not being used.⁷

Important Reminders

It is important to note that although Nexplanon is highly effective at preventing pregnancy, it does not protect against sexually transmitted infections (STIs). Use condoms to reduce the risk of STIs. Also, regular check-ups with your healthcare provider are important to ensure the implant is in place and working correctly.

Questions?

More details are available in the Nexplanon section of our website. If you are considering Nexplanon or would like to discuss other options for contraception or menstrual cycle control, please schedule an appointment with your primary care pediatrician.

¹ The American College of Obstetricians and Gynecologists. (2024, April). Long-Acting Reversible Contraception (LARC): Intrauterine Device (IUD) and Implant Frequently Asked Questions. https://www.acog.org/womens-he...

² McNicholas C, Peipert JF. Long-acting reversible contraception for adolescents. Curr Opin Obstet Gynecol. 2012 Oct;24(5):293-8. doi: 10.1097/GCO.0b013e32835686d5. PMID: 22781078; PMCID: PMC4183267.

³ Nexplanon Label (2023, September). https://www.accessdata.fda.gov...

⁴ The American College of Obstetricians and Gynecologists Committee on Practice Bulletins – Gynecology. Long-Acting Reversible Contraception Implants and Intrauterine Devices. Practice Bulletin. Replaces Practice Bulletin Number 121, July 2011. Reaffirmed 2024. https://www.acog.org/clinical/...

⁵ Rosenstock, Jessica R. MD; Peipert, Jeffrey F. MD, PhD; Madden, Tessa MD, MPH; Zhao, Qiuhong MS; Secura, Gina M. PhD, MPH. Continuation of Reversible Contraception in Teenagers and Young Women. Obstetrics & Gynecology 120(6):p 1298-1305, December 2012. | DOI: http://10.1097/AOG.0b013e31827...

⁶ Organon. Removal. https://www.nexplanon.com/removal/

⁷ Zheng SR, Zheng HM, Qian SZ, Sang GW, Kaper RF. A randomized multicenter study comparing the efficacy and bleeding pattern of a single-rod (Implanon) and a six-capsule (Norplant) hormonal contraceptive implant. Contraception. 1999 Jul;60(1):1-⁸ doi: 10.1016/s0010-7824(99)00053-0. PMID: 10549446.