According to a systematic review published in the Reproductive Health Journal, the etonogestrel contraceptive implant (Nexplanon) has a continuation rate of 57-97% in the first year, but this drops significantly over time. The study highlights that while Nexplanon is highly effective, various factors can influence its effectiveness.
Nexplanon is a popular long-acting reversible contraceptive (LARC) that provides up to three years of birth control. It is a small, flexible rod implanted under the skin of the upper arm, releasing hormones to prevent pregnancy.
In this article, we will explore the factors that can make Nexplanon less effective and discuss ways to ensure its optimal performance.
Key Takeaways
- If Nexplanon isn’t inserted correctly, its effectiveness may be compromised, leading to a higher risk of unintended pregnancy.
- Certain medications, including anticonvulsants, some antibiotics, and HIV treatments, can interfere with Nexplanon’s hormone release and reduce its effectiveness.
- Studies suggest that Nexplanon may be less effective in women with higher BMI, though it remains a reliable choice for most users.
- If Nexplanon is inserted more than 5 days after the start of your period or not replaced on time, its effectiveness decreases.
- Rarely the implant can shift or become dislodged, reducing its ability to prevent pregnancy consistently.
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Factors Affecting Nexplanon’s Effectiveness
Several factors can affect Nexplanon’s effectiveness, including improper insertion, delayed replacement, and missed follow-up appointments. Adhering to the recommended schedule ensures the implant functions correctly and provides continuous pregnancy prevention.
- Improper Insertion: The implant must be placed correctly under the skin of the upper arm by a trained healthcare provider. If inserted too deeply, it may not effectively release the hormone, reducing its ability to prevent ovulation. If placed too close to the surface, it may shift or become difficult to detect, increasing the risk of failure. Proper technique and post-insertion checks help confirm correct placement.
- Delayed Replacement: Nexplanon is designed to be effective for up to three years. If it is not replaced on time, the hormone levels may drop, reducing its ability to prevent pregnancy. Timely removal and reinsertion ensure continued effectiveness.
- Missed Follow-up Appointments: Regular check-ups allow healthcare providers to verify that the implant is in place and functioning correctly. Skipping these appointments can lead to unnoticed issues, such as implant migration or reduced hormone release, which can affect the implant’s reliability.
Following the recommended insertion, replacement, and follow-up schedule is essential for maintaining Nexplanon’s maximum effectiveness and ensuring long-term contraceptive protection.
Drug Interactions
Certain medications can reduce Nexplanon’s effectiveness by interfering with its hormone levels. Anticonvulsants such as carbamazepine and lamotrigine, antibiotics like rifampin, and other drugs, including aprepitant, oxcarbazepine, and some HIV medications, may lower its ability to prevent pregnancy.
Patients taking these medications should use additional contraception for at least 28 days after stopping them to ensure continued protection. It is crucial for individuals using Nexplanon to inform their healthcare provider about all medications, including over-the-counter drugs and supplements. Regular communication with a doctor helps manage potential interactions and ensures Nexplanon remains an effective contraceptive option.
Health Conditions Impacting Effectiveness
Nexplanon is highly effective for most users, but certain health conditions can reduce its ability to prevent pregnancy. Understanding these conditions is essential to ensure the implant works as intended. Several medical factors may affect its effectiveness, and discussing any existing health conditions with a healthcare provider before starting Nexplanon is essential.
- Obesity: Women with a BMI over 30 may experience reduced effectiveness.
- Liver Diseases: Conditions like cirrhosis can affect how the body metabolizes the hormones in Nexplanon.
- Polycystic Ovary Syndrome (PCOS): Hormonal imbalances associated with PCOS may interfere with how Nexplanon works.
- Uncontrolled Diabetes: Poor blood sugar control can affect hormone regulation, potentially reducing efficacy.
It’s essential to work closely with a healthcare provider to manage these conditions and ensure Nexplanon remains a reliable form of contraception. Regular check-ups help maintain its effectiveness.
Ensuring Proper Insertion and Follow-up Care
To ensure Nexplanon works as intended, healthcare providers must follow specific procedures for both its insertion and ongoing care. Proper medical guidance helps maximize the implant’s effectiveness while minimizing potential risks.
- Proper Training: Healthcare providers must have specialized training to place Nexplanon correctly and avoid complications such as nerve or blood vessel damage.
- Pre-Insertion Screening: A thorough evaluation is necessary to rule out contraindications, such as breast cancer, which may make Nexplanon unsuitable for some patients.
- Medication Review: Certain drugs, including anticonvulsants and antibiotics, can reduce Nexplanon’s effectiveness. Doctors should review all medications the patient is taking before insertion.
- Discussion of Side Effects: Patients should be informed about possible changes in bleeding patterns and the implant’s three-year duration to set realistic expectations.
- Follow-Up Appointments: Regular check-ups ensure Nexplanon remains properly placed and continues providing effective contraception.
Understanding the Nexplanon pros and cons allows healthcare providers to minimize risks and ensure patients receive a reliable and well-suited contraceptive option. By addressing key concerns and maintaining proper care, doctors help patients make informed decisions about their birth control choices.
Conclusion
Nexplanon is a highly effective long-term contraceptive option, but its success depends on proper insertion, timely replacement, and awareness of factors that may reduce its effectiveness. Medications, underlying health conditions, and missed follow-ups can all play a role in decreasing its reliability.
By staying informed about Nexplanon’s pros and cons, patients can make educated decisions about their birth control options. Consulting a healthcare provider, attending regular check-ups, and following recommended guidelines can help maximize the implant’s effectiveness and ensure continued protection against pregnancy.
FAQs
1. What is Nexplanon?
Nexplanon is a small, flexible implant placed under the skin of your upper arm that releases hormones to prevent pregnancy.
2. How effective is Nexplanon?
Nexplanon is over 99% effective at preventing pregnancy when used correctly.
3. Are there side effects of Nexplanon?
Some common side effects include irregular bleeding, headaches, weight gain, mood changes, and acne.
4. Can I use Nexplanon if I’m breastfeeding?
Yes, Nexplanon is safe to use while breastfeeding, as it does not affect milk production.
References
Moray KV, Chaurasia H, Sachin O, Joshi B. A systematic review on clinical effectiveness, side-effect profile and meta-analysis on continuation rate of etonogestrel contraceptive implant. Reproductive Health. 2021;18(1). doi:10.1186/s12978-020-01054-y
Long-Acting reversible contraception implants and intrauterine devices. ACOG. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2017/11/long-acting-reversible-contraception-implants-and-intrauterine-devicesFastStats. Contraceptive Use. https://www.cdc.gov/nchs/fastats/contraceptive.htm
