From the Guidelines
No, Nexplanon cannot be used as emergency contraception. Nexplanon is a long-acting reversible contraceptive implant containing etonogestrel that is inserted under the skin of the upper arm to provide contraception for up to 3 years. It works by continuously releasing a small amount of progestin to prevent pregnancy by inhibiting ovulation, thickening cervical mucus, and thinning the uterine lining. For emergency contraception after unprotected sex, appropriate options include levonorgestrel pills (Plan B One-Step, taken within 72 hours), ulipristal acetate (ella, effective up to 5 days), or a copper IUD (ParaGard, most effective when placed within 5 days) 1. These emergency methods work by either delaying ovulation or preventing fertilization/implantation after unprotected intercourse, while Nexplanon is designed for ongoing prevention rather than emergency use.
Some key points to consider when choosing an emergency contraception method include:
- The copper IUD can be inserted within 5 days of the first act of unprotected sexual intercourse as an emergency contraceptive 2, 3
- Ulipristal acetate may be more effective than levonorgestrel formulations after the first 72 hours and for women who are overweight or obese 1
- The efficacy of the copper IUD is not affected by antiretroviral agents, but interactions may occur with other types of emergency contraception 4
If you need emergency contraception, contact a healthcare provider or pharmacy immediately to discuss appropriate options. It is essential to note that while Nexplanon is an effective form of contraception, it is not designed for emergency use and should not be relied upon as a method of emergency contraception.
From the Research
Emergency Contraception Options
- The available evidence does not specifically mention the use of Nexplanon as an emergency contraception method 5, 6, 7, 8, 9.
- However, it is known that Nexplanon is a long-term reversible contraception method that exerts its effects primarily by suppressing ovulation 7, 8.
- The most effective methods of emergency contraception include the copper intrauterine device and ulipristal acetate, with levonorgestrel being another option 5, 6, 9.
Nexplanon Characteristics
- Nexplanon is the only contraceptive implant currently available in the United States 8.
- It is the most effective method of long-acting reversible contraception, with a rapid return to fertility once removed 8.
- The implant should be removed by the end of the third year of use, and all health care providers must be trained on Nexplanon before performing insertions or removals 8.
Emergency Contraception Studies
- A study comparing levonorgestrel and copper intrauterine devices for emergency contraception found that the levonorgestrel IUD was noninferior to the copper IUD for this purpose 6.
- Another study examined the use of ulipristal acetate, levonorgestrel, and the copper-intrauterine device for emergency contraception following the introduction of new guidelines, and found that the use of levonorgestrel fell while the use of ulipristal acetate increased 9.