The Birth Control Implant Is Over 99 Percent Effective, But It's The Least Popular Contraceptive

If, like me, you keep seeing those "I armor up" commercials while binge-watching Broad City on Hulu, you might be curious about how Nexplanon works. Just how effective is Nexplanon, the birth control implant that goes in your arm? According to the product website, Nexplanon is over 99 percent effective. This means that there was less than one pregnancy per 100 women who used Nexplanon for one year, a fact that Merck & Co. — the pharmaceutical company that manufactures Nexplanon — confirmed in an interview with Elite Daily.

"Merck is committed to providing women with a range of birth control options, including Nexplanon," Rick Gersh, MD, Global Director of Medical Affairs at Merck tells Elite Daily. "Nexplanon is an arm implant that prevents pregnancy and is part of a category called long-acting reversible contraception, also known as LARC, which are among the most effective birth control options available. When placed correctly in the arm, Nexplanon is over 99 percent effective, with less than one pregnancy per 100 women for one year. It is similar in effectiveness as methods such as injections, intrauterine devices, and even sterilization."

Birth control implants are proven to be one of the most effective, reversible types of contraceptive available, according to the CDC. Nexplanon is much more effective than the Pill and condoms are at preventing pregnancy, and it is even slightly better than other long-term contraceptives like IUDs. According to the CDC, 0.05 percent of general implant users got pregnant in a given year, compared to 0.2 percent of hormonal IUD users and 9 percent of women who used birth control pills.

So, why is this specific birth control implant also the least popular form of contraceptive? According to data from The Guttmacher Institute, fewer women use Nexplanon than any other method. There are 10 times as many women using IUDs as there are who use the implant.

I spoke to Dr. Leah Millheiser, director of the female sexual medicine program at Stanford University Medical Center, about this relatively new form of birth control, the training required for a gynecologist to safely insert the implant, and whether the benefits of Nexplanon outweigh the possible side effects.

Nexplanon works in three main ways.
Stocksy/Thais Ramos Varela

"Nexplanon is a progestin-only, subdermal implant that is placed in the inner, upper arm by a healthcare provider," a Merck spokesperson tells Elite Daily. It's a single implant, consisting of one, 4 centimeter-long device.

"Nexplanon works in three ways. The first, most effective way it works, the way that it really promotes birth control, is through stopping the egg from being released from the ovary," says Dr. Millheiser. "The second is that it can thicken up the cervical mucus and make it harder for sperm to move through the cervical canal. And third, it thins the lining of the uterine cavity, making it an inhospitable environment for a fertilized egg."

The prevention of pregnancy in the implant is similar to the IUD, because you don't have to remember to take something every day, like you do with the birth control pill. "The user error is eliminated," says Dr. Millheiser. "That's why Nexplanon and the IUDs are so effective. They're placed, and then you can forget about it for a couple of years."

There are both benefits and potential downsides to the implant.
Stocksy/Aleksandra Jankovic

"Do I think the benefits outweigh risks? Absolutely," says Dr. Millheiser. "The risk of an unintended pregnancy, the benefits of Nexplanon definitely outweigh that. There's a little bit of discomfort when you get the lidocaine injected into your arm, but that's it. Then you don't feel it."

It's a great form of contraception, especially for a woman who is not planning on getting pregnant for at least three years, according to Dr. Millheiser. Nexplanon is a three-year implant, and she says that the removal process takes a little longer than for an IUD. You have to remember to make an appointment, go in, and have a small procedure done in the office to remove the implant, during which the arm is also numbed again.

Dr. Millheiser believes that some women feel getting an IUD put in and taken out is easier, and therefore choose that form of long-acting, reversible contraceptive instead of the implant. There are also women who just don't want to have an implant under their arm.

"They feel uncomfortable feeling it, having others feel or see it. There might be that stigma, like, 'people know that I'm using contraception,' which is silly. The women herself can feel it, and you want to be able to feel it," says Dr. Millheiser.

The most common side effect is irregular bleeding.
Stocksy/Audrey Shtecinjo

"Some women have irregular bleeding, which can be problematic. That's probably the most common reason people have Nexplanon removed," says Dr. Millheiser. "They may have spotting for several months before their period stops. Their periods may be heavier than normal, and for some women, they actually may lose their periods altogether."

While this reaction is not unlike that of a progestin IUD, for some women, it can be worrisome. "They want their period to let them know that they're not pregnant," adds Dr. Millheiser.

For some women, there may also be a small amount of weight gain. Overall, the side effects are similar to progestin IUDs, though there may be more of an irregular bleeding pattern, according to Dr. Millheiser. "Refer to Important Safety Information for side effects," a spokesperson tells Elite Daily in a Merck response.

There's a learning curve for gynecologists.

While most doctors do place IUDs, a lot of clinicians don't recommend Nexplanon, simply because they aren't trained in how to insert the implant. It's a newer type of contraception, and not every doctor has learned how to make the small incision and put it into the arm.

"Nexplanon is not [inserted into] the vagina or the uterus that we're so used to as gynecologists," says Dr. Millheiser. "There's a learning curve. IUDs have been around for decades, so most older clinicians know how to put an IUD in really easily."

"Merck offers an in-person clinical training program to all eligible healthcare providers on the insertion and removal of Nexplanon," a spokesperson tells Elite Daily in a Merck response.

Every person's body reacts a little differently to different birth control methods. What works for your friend may not work the same way for you. If you're interested in using Nexplanon as your birth control method, talk to your gynecologist to find out if it's the right fit for you.

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