When it comes to long-term reliable contraception, most people think of an intrauterine device (IUD). However, there is another convenient and highly effective option — the subdermal implant Implanon / Nexplanon. This is a long-acting reversible contraceptive (LARC) that provides protection for up to 5 years. Previously, the implant was recommended to be replaced after 3 years. However, modern clinical studies have demonstrated that contraceptive effectiveness is maintained for up to 5 years, which is now reflected in clinical practice recommendations.
After insertion, the implant is placed under the skin and gradually releases microdoses of etonogestrel — a modern progestin. The hormone gently acts on the pituitary gland — the “control center” of the reproductive system — suppressing ovulation, meaning it temporarily prevents the release of an egg from the ovaries. In addition, etonogestrel changes the properties of cervical mucus, making it thicker and more viscous. In such an environment, sperm have significantly more difficulty reaching the egg. This creates a reliable, multi-level protection against pregnancy.
For comparison:
• Hormonal implants — more than 99% effective
• Intrauterine devices (IUDs) — about 99% effective
• Tubal ligation (surgical sterilization) — more than 99% effective and considered permanent
• Oral contraceptive pills — about 91% effective
It is important to understand that in terms of effectiveness, the implant is comparable to sterilization, while remaining fully reversible — fertility returns after removal. That is why the implant is often considered an alternative to tubal ligation for women who want highly reliable but non-permanent contraception.
Additional therapeutic effects
Beyond its high contraceptive effectiveness, Nexplanon may also provide additional therapeutic benefits. For this reason, in clinical practice the implant is sometimes considered not only as contraception but also as a way to help manage certain gynecological conditions.
Reduction of menstrual pain
One of the most noticeable effects is a decrease in menstrual pain. By suppressing ovulation and thinning the endometrium, the production of prostaglandins — substances responsible for uterine contractions and pain — is reduced. As a result, periods become less painful, and the need for pain medication may decrease. Observational data show that many women experience improvement within the first months of use.
Decreased menstrual blood loss
With Nexplanon, the endometrium becomes thinner and less vascularized. This may lead to:
• reduced menstrual volume
• shorter duration of bleeding
• in some cases — complete absence of menstruation (amenorrhea)
It is important to emphasize: absence of menstruation while using the implant is an expected and safe effect related to hormonal action, not to “blood accumulation.”
Prevention of iron deficiency
By reducing blood loss, the risk of developing or worsening iron-deficiency anemia decreases. For women with heavy menstrual bleeding, this may be a significant additional benefit.
Possible benefit in endometriosis
Since progestins suppress ovulation and reduce endometrial activity, the implant may help decrease symptoms associated with endometriosis, including pelvic pain. Although it is not a primary treatment for endometriosis, some patients experience clinical improvement.
Possible side effects: what to know in advance
Like any hormonal method, the implant may affect the body. In most cases, changes are predictable and safe, but it is important to know what to expect.
Changes in menstrual pattern — the most common effect
Menstrual changes are the most frequent effect of implant use. Possible changes include:
• irregular bleeding
• spotting between periods
• shorter or longer cycles
• complete absence of menstruation (amenorrhea)
Less commonly reported:
• headaches
• mood changes
• emotional sensitivity
• decreased libido
• breast tenderness
• acne
In most cases, side effects decrease within the first months as the body adapts to a stable hormonal background. If symptoms are pronounced or uncomfortable, you can always consult your doctor and discuss further options — the implant remains a reversible method.
The implant protects against pregnancy but does not protect against sexually transmitted infections (STIs). If there is a risk of STIs, barrier contraception is recommended.