From the Guidelines
Nexplanon is effective for up to 3 years, after which it should be removed and replaced if continued contraception is desired. The implant works by releasing a steady, low dose of the hormone etonogestrel, which prevents pregnancy primarily by stopping ovulation and thickening cervical mucus to block sperm 1. According to the most recent evidence, Nexplanon has a failure rate of 0.2% and is approved for use by the FDA for 3 years 1.
Key Points to Consider
- The effectiveness of Nexplanon is not dependent on the timing of insertion during the menstrual cycle, but a backup method of contraception may be needed for 7 days after insertion if inserted at any other time during the menstrual cycle 2.
- Nexplanon is over 99% effective, making it one of the most reliable birth control methods available 3.
- While Nexplanon prevents pregnancy, it does not protect against sexually transmitted infections, so condoms may still be necessary depending on the situation 3.
- The implant can be inserted at any time, and the benefits of starting the implant likely exceed any risk if the healthcare provider is uncertain whether the patient might be pregnant 2.
Important Considerations for Healthcare Providers
- When starting an implant, patients should be counseled that a backup method (e.g., condoms or abstinence) should be used for at least the first week for contraceptive efficacy and that a condom should be used at all times for protection against STIs 3.
- The main theoretical concern about contraceptive implant use in the postpartum period is whether the progestin might have some effect on breastfeeding; however, studies of contraceptive implant use among breastfeeding women have generally found no effects on breastfeeding performance or infant health and growth 3.
From the Research
Effective Duration of Nexplanon
The effective duration of Nexplanon, an etonogestrel (EG) implant, is as follows:
- The implant should be removed by the end of the third year of use 4
- It is possible to extend the use of the etonogestrel-implant beyond three years 5
- A study investigated the efficacy, safety, removal characteristics, and x-ray visibility of Nexplanon over a 3-year period 6
Key Characteristics
Some key characteristics of Nexplanon include:
- High contraceptive effectiveness with a single intervention 5
- Can be used for a long time 5
- Provides clinicians with a long-term hormonal contraceptive method with a safety and efficacy profile comparable to Implanon 6
- Exerts its contraceptive effects primarily by suppressing ovulation 4
Removal and Fertility
After removal of the implant: