How Effective is Nexplanon? – Understanding Its Contraceptive Reliability

Intrauterine devices (IUDs) and other long-acting reversible contraceptives (LARCs) are among the most effective birth control methods available. According to the Centers for Disease Control and Prevention (CDC), IUDs and implants have a failure rate of less than 1%, making them significantly more reliable than birth control pills or condoms.

Nexplanon, a progestin-only contraceptive implant, belongs to this category of highly effective birth control options. Inserted just under the skin of the upper arm, it releases etonogestrel to prevent pregnancy for up to three years. While its effectiveness rivals that of IUDs, some users may have concerns about its reliability and potential side effects.

In this article, we will explore Nexplanon’s effectiveness, compare it to other contraceptive methods, and examine the factors that influence its reliability.

Key Takeaways

• Nexplanon is over 99% effective in preventing pregnancy by suppressing ovulation, thickening cervical mucus, and thinning the uterine lining.
• It releases etonogestrel, a synthetic progestin, to block fertilization and implantation.
• Proper insertion and timely replacement every three years are essential to maintain its effectiveness.
• Factors like incorrect placement, medication interactions, and metabolic differences (including BMI) may impact its reliability.
• Compared to other contraceptives, Nexplanon offers greater convenience, eliminating the need for daily pills or frequent doctor visits like injectables require.

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How Nexplanon Prevents Pregnancy

Nexplanon works by releasing etonogestrel, a synthetic progestin, which prevents pregnancy through three key mechanisms:

• Ovulation Suppression: Etonogestrel inhibits egg release from the ovaries, preventing fertilization.
• Cervical Mucus Thickening: The hormone thickens cervical mucus, making it difficult for sperm to reach an egg.
• Endometrial Thinning: Nexplanon alters the uterine lining, reducing the likelihood of implantation if fertilization occurs.

Together, these effects make Nexplanon over 99% effective, providing one of the lowest pregnancy rates among contraceptive options.

Factors That May Impact Nexplanon’s Effectiveness

Although Nexplanon is highly reliable, certain factors may influence its effectiveness. These include insertion technique, medication interactions, and individual metabolic differences.

• Improper Insertion or Migration: If the implant is incorrectly placed or shifts from its original position, hormone release may be inconsistent, reducing its efficacy.
• Medication Interactions: Certain drugs, such as anti-seizure medications, HIV treatments, and some antibiotics, can induce liver enzymes that break down etonogestrel more quickly, potentially reducing effectiveness.
• BMI and Metabolism: Research suggests that individuals with higher body mass indexes (BMIs) may experience slightly lower hormone levels over time. However, Nexplanon remains highly effective for most users, regardless of weight.

Users should consult their healthcare provider if they take medications that could interfere with Nexplanon or if they experience concerns about its placement.

Comparing Nexplanon to Other Contraceptive Methods

Nexplanon is often compared to other long-acting and short-term birth control options. Below is a comparison of its effectiveness and convenience against other popular methods:

Method	Effectiveness	Hormone Release	Duration	User Convenience
Nexplanon vs. IUDs	Both offer over 99% efficacy.	Nexplanon releases systemic hormones, while IUDs (copper or hormonal) work within the uterus.	IUDs last 5–10 years, while Nexplanon requires replacement every three years.	IUDs require a one-time insertion, while Nexplanon is long-term and needs an earlier replacement.
Nexplanon vs. Birth Control Pills	Pills have a typical failure rate of around 9%, often due to missed doses.	Nexplanon maintains consistent hormone levels without daily intervention.	Pills require daily use, while Nexplanon lasts for three years.	Nexplanon removes the risk of user error, whereas pills require strict adherence.
Nexplanon vs. Injectables (e.g., Depo-Provera)	Both methods contain progestin and are highly effective.	Injectables require a new shot every three months, while Nexplanon provides continuous hormone release.	Depo-Provera requires quarterly injections, while Nexplanon lasts three years.	Nexplanon is more convenient, eliminating the need for frequent doctor visits. Depo-Provera may cause more significant weight fluctuations.

Real-World Data vs. Clinical Trials

Clinical trials have shown that Nexplanon has a failure rate of less than 0.1%, making it one of the most reliable contraceptive options available. This means that fewer than 1 in 1,000 users will become pregnant within a year when the implant is inserted correctly. Its high efficacy is comparable to other long-acting reversible contraceptives, providing users with consistent, long-term pregnancy prevention.

While clinical trials confirm Nexplanon’s high efficacy, real-world factors can slightly influence its performance. Incorrect insertion, higher body weight, or interactions with certain medications may reduce effectiveness. Some users also question, “Does Nexplanon cause weight gain?“ While research suggests no significant fat accumulation, individual responses may vary due to hormonal changes and metabolism.

Its official approval remains three years, and users should consult their healthcare provider about timely replacement for optimal protection.

Conclusion

Nexplanon remains one of the most effective long-term contraceptive options, providing reliable pregnancy prevention with minimal maintenance. To maximize its benefits, healthcare providers should ensure proper insertion, assess potential drug interactions, and educate patients on timely replacement. As research continues to explore Nexplanon’s extended efficacy, its role as a top-tier birth control method remains well-established.

FAQs

1. How effective is Nexplanon compared to an IUD?

Both methods are over 99% effective, but IUDs last longer (5–10 years) than Nexplanon, which lasts three years. Nexplanon provides systemic hormone release, while IUDs primarily act within the uterus.

2. Can Nexplanon stop working before three years?

While Nexplanon is designed to last three years, factors like high BMI or certain medications may reduce hormone levels earlier. If users have concerns, they should check with their doctor.

3. Does Nexplanon need to be replaced precisely at three years?

Yes, the implant should be replaced within three years for optimal effectiveness. Some studies suggest it may work longer, but current recommendations support timely removal and reinsertion.

4. Can Nexplanon be removed if I want to get pregnant?

Yes, Nexplanon can be removed at any time. Fertility typically returns quickly, allowing users to conceive soon after removal.

References

Ali M, Bahamondes L, Landoulsi SB. Extended Effectiveness of the Etonogestrel-Releasing Contraceptive Implant and the 20 µg Levonorgestrel-Releasing Intrauterine System for 2 Years Beyond U.S. Food and Drug Administration Product Labeling. Global Health Science and Practice. 2017;5(4):534-539. doi:10.9745/ghsp-d-17-00296

Centers for Disease Control and Prevention. (n.d.). About contraception. Retrieved from https://www.cdc.gov/contraception/about/index.html 

Centers for Disease Control and Prevention. Implants. Contraception. (n.d.). https://www.cdc.gov/contraception/hcp/usspr/implants.html