Nexplanon®, the only subdermal contraceptive implant (ENG implant) available in Canada, is long-acting, immediately reversible and highly effective (99%). Safe and effective in both postpartum and postabortion settings, the ENG is also appropriate for women who can’t take estrogen.
Nexplanon (ENG implant) works in three ways:It stops your ovaries releasing an egg every month.It thickens the mucous you produce from your cervix making it more difficult for the sperm to get to the egg.It thins the lining of the womb, making it less likely that a fertilized egg will implant in the womb.
The ENG implant is a single-rod, progestin-only contraceptive implant measuring 4 cm in length and 2 mm in diameter that contains 68 mg of the progestin etonorgestrel. Once inserted just under the skin of a woman’s arm, the ENG implant prevents ovulation for up to three years.
If the implant is inserted during the first 5 days of your period, it is effective immediately.
If the implant is inserted any other time during your cycle, you will need to use backup contraception for example condoms for the first 7 days after which the implant is effective in preventing pregnancy.
If you have just had a baby, the implant can be fitted three weeks after the birth of your baby.
The implant can be fitted immediately after a miscarriage or abortion and will start working straight away.
The implant costs approximately $ 350.00. This may be covered by your extended health plan. It is not currently covered by NIHB or social services.
Insertion of the ENG implant is an office procedure done in our clinic under local anesthesia with sterile instruments by Dr Gerber, an ENG-trained clinician. The procedure takes two-three minutes.
You will be given a local anaesthetic injection to numb a small area on your arm similar to getting an injection.
A dressing will be placed over the site which should be worn for 24 hours. You should be able to feel the implant under your skin, but it will not affect how you move your arm. After your fitting your arm may feel tender and bruised for a few days. The bruising may last a week or two.
Minimal attention is required once the ENG is in place. Women are advised to check the placement once a month. You should be able to feel both ends of the rod under your skin. If you are unable to at any time feel the implant, contact your physician for a consultation.
Some medications may affect the effectiveness of the implant especially drugs for epilepsy, TB, HIV and also St John’s Wort. Always check with the doctor or nurse that your usual medication will not interact with Implant.
Follow up is not needed once the implant is fitted. You will only need to come to the clinic when your implant is fitted or removed or if you have a problem with your implant.
If you cannot feel the ENG, please contact the clinic. The most common side effect is unscheduled bleeding.
However, for many women who have trouble remembering to use the pill, patch or ring, or who do not wish to have an IUD placed inside the uterus, this is a reliable and user-friendly birth control method.
Implant removal can also be done in the office under local anesthesia by Dr Gerber, an approved ENG-trained clinician.
If you’ve had your implant for 3 years and you require ongoing contraception, the implant should be removed, and you can get a new implant at the same time as the removal.
Alternatively, the implant can be removed, and you can choose to switch to a different type of birth control.
You will have a local anaesthetic injection to numb the area. It usually only takes a few minutes to remove the implant. You will be left with a small scar on your inner arm.
You should feel completely normal after having your implant removed. Your arm may feel tender or swollen around the area where the implant used to be and it may look bruised for a week or two. You will be asked to keep the area dry for 24 hours.
What are the advantages of using a Nexplanon (ENG) contraceptive implant?
It works for three years.
It doesn’t interfere with sex.
It is discrete and no one should be able to see the implant under the skin of your arm.
Contraceptive implants are reversible. If you decide you want to get pregnant, you can get it removed at any time. The implant won’t affect your fertility or make it harder to get pregnant in the future. In fact, it’s possible to get pregnant as soon as it is removed.
It can be used if you’re breast feeding.
It is useful if you cannot take Estrogen (the hormone contained in the combined oral contraceptive pill, patch or ring) It may reduce heavy painful periods.
Very rarely having an implant fitted or removed from your arm can cause an infection and on rare occasions it can be difficult to remove the implant from your arm.
Your periods may change in a way that is not acceptable to you. In some women the periods will stop all together, others may have irregular periods or periods that last longer than usual. The changes to your periods can be a nuisance but they are not harmful. Please return to our clinic for advice if you are experiencing prolonged bleeding. We can help control the bleeding by giving you some additional hormone (in the form of “the pill”) for a short time.
Other possible side effects include headaches, acne, tender breasts, weight gain and mood changes but these side effects are not common.
The implant only protects you from pregnancy. It does not protect you against sexually transmitted infections. Using condoms every time you have sex lowers your chances of getting or spreading STI’s.
Research about the risk of breast cancer and hormonal contraception is complex and contradictory.
Research suggests that users of all hormonal contraception may have a small increase in risk of being diagnosed with breast cancer compared to non-users.
This implant is not suitable for every woman.
The following conditions may mean that this implant is not suitable for you.
- If you think you may be pregnant.
- You do not want your periods to change.
- You have now or have had in the past: