Contraceptive implant removal & fitting guide

With the contraceptive implant (Nexplanon) needing to be fitted under the skin in your arm, it can feel like one of the more daunting contraceptives to get on board with.

But whilst the implant may seem an initially uncomfortable way to protect yourself from pregnancy, it’s a highly effective (over 99%) long-term contraceptive solution which can be removed at any time if causing side effects (check out our reviewers’ real experiences and side effects). 

With questions around the implant removal and fitting often front-of-mind when exploring this type of contraception, we’ve pulled together a detailed guide on what to expect for this procedure.

The contraceptive implant at a glance

• The implant is a small matchstick sized rod that is inserted into the arm
• The brand used in the UK is called Nexplanon
• The implant works by steadily releasing the hormone progestogen into your bloodstream, which prevents the release of an egg each month. It also thickens the cervical mucus, preventing sperm from getting through, and thins the lining of the womb so a fertilised egg cannot implant into it
• The implant is over 99% effective at preventing pregnancy. 
• The contraceptive implant only needs to be replaced every three years
• The implant can be removed at any time if it is causing side effects
• It is safe to use whilst breastfeeding
• Where the implant is inserted it may feel bruised for a week or two after
• You can resume daily activities immediately after the implant has been fitted
• The implant may cause irregular bleeding, infrequent bleeding, spotting, prolonged periods or stop your periods altogether. The pattern of bleeding tends to settle down after 3 to 6 months
• The implant can be fitted at any time during your cycle as long as you’re not pregnant. If fitted in the first 5 days of your cycle you are protected against pregnancy straight away. If fitted at any other time within your cycle you will need to use condoms for the first 7 days
• The implant may cause side effects such as acne, breast tenderness, headaches and mood changes
• You are no longer protected from pregnancy as soon as the implant is removed and your fertility will return to what is normal for you

Having the contraceptive implant fitted – your questions answered

How big is the contraceptive implant?

The implant is approximately 4cm long, which is roughly the size of a matchstick.

Where does the contraceptive implant go?

The contraceptive implant is fitted just under the skin on the inside of your upper arm. It will usually be inserted in your non-dominant arm (i.e. if you’re right handed it will be inserted in your left arm). 

Does the contraceptive implant hurt?

Before the contraceptive implant is fitted you will be given a local anaesthetic either as an injection or spray which will numb the area. The implant is then inserted under the skin.

How long will the Nexplanon implant take to be fitted?

The contraceptive implant is very quick to be fitted, and should only take a few minutes to be inserted. 

Will my arm hurt after the implant has been inserted?

Once the local anaesthetic has worn off you may experience some tenderness in your arm for a couple of days after. 

Will I need stitches in my arm after the implant has been inserted?

No stitches are required for this procedure. 

How do I know that the Nexplanon implant has been inserted correctly?

Immediately after insertion your healthcare provider will feel to check that it has been inserted correctly and teach you to do the same. If at any time following the insertion you cannot feel the implant, then contact your healthcare provider and use extra contraceptive precautions (such as condoms) until they have checked that it is in place. 

When does the contraceptive implant start working?

If you have the implant fitted in the first 5 days of your period, within 5 days after an abortion, or within 21 days of giving birth, it works immediately to prevent pregnancy. If you have the implant fitted at any other time, you should avoid sex or use condoms for 7 days until it starts working. Sometimes your healthcare professional might advise you to take a pregnancy test after the implant has been fitted if you have had unprotected sex before it was inserted.

Can I have the implant fitted if I’m pregnant? 

The contraceptive implant cannot be fitted if you are pregnant. Your healthcare professional may ask you to do a pregnancy test prior to insertion to ensure that you are not pregnant before your fitting. 

What is the contraceptive implant aftercare?

The area of your arm where the implant is fitted will be covered with a dressing and a bandage. You should keep the site dry and clean for 24-48 hours post insertion. 

Will having the implant fitted affect my periods?

Yes, many women find a change in their periods once they have the implant fitted. This could include spotting or lighter periods, as well as irregular or infrequent bleeding. A common side effect is that your periods may stop altogether. This is not harmful and potentially very beneficial, especially if you have heavy or painful periods.

Can I get my contraceptive implant fitted on the NHS?

Absolutely. You can have it fitted at contraceptive clinics, sexual health clinics, some GP surgeries, and some young people’s services. Find a sexual health clinic. 

Is the contraceptive implant free?

Yes all NHS services that fit contraceptive implants will fit it for free.

Can I have the implant fitted by a private clinic?

Yes, there are multiple private clinics offering implant fittings. The cost for the implant to be fitted is approximately £300, but will vary from clinic to clinic. 

Contraceptive implant removal – your questions answered

When can I have the implant removed?

You can have your implant removed at any time by a health professional. Your implant may be about to expire, you may be experiencing side effects, or you may wish to get pregnant. If you do not wish to get pregnant consider switching to another method of contraception before having your implant removed, or avoid unprotected sex in the 7 days before the implant is removed. Once the implant is removed you can get pregnant and your fertility will return to what is normal for you.

What to do if you’ve had unprotected sex before your implant removal

If you have had unprotected sex within the 7 days before your implant removal appointment, tell your healthcare professional and they will delay the removal. If you have already had the implant removed and realise that you had sex without a condom in the 7 days before, speak to a healthcare professional as you may require emergency contraception if you don’t want to get pregnant.

If I’m experiencing no implant side effects, how long until I need my contraception replaced?

Your implant can stay in place in your arm for three years before it needs to be replaced. 

How is the implant removed from my arm?

The healthcare professional will feel for your implant before they remove it. A local anaesthetic will then be administered, and a tiny cut will be made in your skin to pull the implant out.

Does implant removal hurt?

Removal will be relatively painless as your health professional will have administered a local anaesthetic. 

How long does it take for the implant to be removed?

It usually only takes a few minutes for the implant to be removed by your healthcare professional. 

Side effects of the contraceptive implant removal

The main side effects of implant removal are discomfort and bruising. Occasionally there can be an infection or a small scar.

Is there a risk of infection after contraceptive implant removal?

In very rare cases the site of the implant may become infected. If the skin becomes red, painful or swollen or you feel unwell, contact your doctor. 

Will I experience any bruising on my arm after the removal?

You may experience slight bruising and tenderness after the removal. This should go down after a few days. 

Will I get a scar on my arm once the implant has been removed?

In most cases you will not be left with a noticeable scar. 

Can I get pregnant once the implant has been removed?

Yes your normal fertility will return on removal of the implant and it is possible to get pregnant as soon as the implant has been removed. If you do not wish to get pregnant we recommend using condoms or switching to another method of contraception. 

When to take a pregnancy test after implant removal

After your implant has been removed, you should take a pregnancy test 21 days after the last time you had unprotected sex without a condom. When your cycle has returned, if you are trying to conceive, you should take a pregnancy test on the 1st day of your expected period.

Is it dangerous if I go past the three year life span of my implant before getting it removed?

It is not dangerous to keep the implant in, but it will be less effective which will increase the risk of pregnancy. To maintain contraceptive cover you should have your implant replaced after three years. During the Covid-19 pandemic the Faculty of Sexual and Reproductive Health (FSRH) advised that whilst the risk of pregnancy during the fourth year of use appears to be very low, contraception cannot be guaranteed and women may wish to use additional contraceptive precautions until they are able to attend an appointment for their Nexplanon replacement.

Side effects of the contraceptive implant (Nexplanon)

Lowdown users have reported their side effects of the implant on our website. The following data was taken from September 2024.

• Irregular periods (45% of our reviewers stated this as a side effect)
• No periods at all (33%)
• Spotting between your periods (13%)
• Lighter or infrequent periods (4%)
• Mood changes (38% of our reviewers had negative mood chages)
• Weight changes (41% of the reviwers gained weight)
• Breast tenderness (51% of users)
• Increased spots or acne (although 61% of our users had no change in their skin)
• Change in sex drive (50% of our reviewers stated a reduction in sex drive)
• Vaginal discharge (41%)
• Vaginal dryness (38%)

For further information on side effects and risks, see our complete guide and reviews of the contraceptive implant. The statistics quoted in this blog were up to date at the time of writing but may change as more of you leave reviews!