Fed up after seven years of taking birth control pills every day but unsure about getting an IUD, one woman finally found an easier, more convenient form of long-term contraception that worked for her lifestyle. 

Julia Naftulin
September 15, 2017

In eleventh grade, I got my first serious boyfriend—and with him came my first birth control pill prescription, per my mother's insistence. I remember my mom taking me to her gynecologist, the man who delivered me, for a consultation. "Look how big you are! I can't believe it!" he said when he saw me. Cringe.

After that first visit, I used the pill for the rest of high school and all four years of college. It was easy enough to stop at my local pharmacy each month for a refill—until it wasn't. During my junior year of college, I geared up to study abroad for my spring semester. Preparation included getting a 5-month supply of pills to take with me.

Sounds easy, right? It was quite the opposite. Attempting to get five months of birth control pills involved hours of back-and-forth phone calls with my insurance company, pharmacy, and gynecologist's office. Each said they couldn't help me. In the end, my mom mailed my supply to Paris from Pennsylvania at the beginning of every month. Then I found out I was paying a monthly $30 copay when a generic version of the same pill would've been free. I was enraged.

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This debacle, along with the 2016 presidential election—which put the cost and access of hormonal contraception front and center—compelled me to make a change. First, I would find new, more helpful gynecologist. Then I would find out more about Nexplanon, the birth control implant that works as a semi-permanent contraceptive option. After all of the fuss I experienced in the past, I was eager to find a long-term solution that involved fewer visits to the doctor.

I had been considering getting an IUD, which I knew was a long-term method that was very effective at preventing pregnancy. But then I remembered that two of my college roommates had been on Nexplanon. They raved about how they didn't have to worry about taking a pill or refilling a prescription, since once Nexplanon is in, it's effective for up to 3 years.

Sounds like birth control witchcraft, right? I looked into it more and found out how it works. The match-size, flexible, rod-shaped implant is inserted by a doctor into a woman's arm, right under the skin near the inner bicep. The implant releases hormones that put the brakes on ovulation, just as taking a daily pill stops ovulation. It also makes the mucus in the cervix thicker, so if ovulation happens to occur, sperm are unlikely to make it through the cervix and reach a waiting egg. 

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During a consult with my new gynecologist, I also found out that Nexplanon, like all hormonal birth control methods, has side effects. Some were similar to those of oral contraceptives, like spotting between periods, weight gain, and mood swings. Acne was another possibility. Unlike the pill, Nexplanon doesn't have estrogen. Instead, it's made with the hormone etonogestrel, which is released slowly into the bloodstream for three years. After that, you have it taken out and replaced with a new rod.

After weighing the pros and cons, I made an appointment for the procedure. One annoying caveat: you must schedule the implant for when you don't have your period. Since I still travel to Pennsylvania for doctor appointments from New York (shout out to staying on your parents' insurance for as long as possible), but with careful planning, I was able to book an appointment after my period ended.

As I waited for the gynecologist to enter the room, I noticed the unopened implant on the table. I remember thinking, how is that huge thing going to fit in my arm? In reality, the device is 1.6 inches long.

After answering my questions, my gynecologist got started. She sterilized my arm where the implant would be inserted and gave me a shot of a local anesthetic. Once I was numb, she advised me to look away. "You won't feel anything but the pressure of my hand, but seeing the implant enter your arm can be a bit freaky," she told me. My mom, who came with me to the appointment, chimed in: "Well, I'm a nurse and live for these things, so do you mind if I watch?"

And so she saw the entire 15-second procedure. It was very anticlimactic, and like the doctor said, I didn't feel a thing. There was no blood, only a small incision in my bicep where the implant was inserted. She wrapped the area in gauze and told me to leave it on until the next morning. 

As the day went on, my bicep looked more and more bruised, which I was told would happen, and the area was tender. These symptoms went away after a week. Now, the only trace of the implant is a barely visible whitish mark on my right bicep, and if you press on the implant area, you can feel the tiny but solid metal bar.

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Since getting Nexplanon 7 months ago, my periods and the painful cramps that came with them have completely disappeared, and I no longer have to refill or remember to take my pill. My only complaint is the effect the implant had on my complexion. I was lucky enough never to be plagued by breakouts, but now my skin is oilier than ever before and I started having acne. But in time I figured out a new skincare regimen to keep zits from popping up.

For anyone looking for a long-term birth control option, hates inconvenient visits to the doctor or pharmacy, or is just not all that good at consistently taking a pill every day, Nexplanon maybe worth your while. It's also a good alternative if you're unsure about an IUD, as I was.