Implant (the rod)
The one in your arm that does the hard work for you - hormonal, hands-off, and here for a good (long) time.
Gets an A+ in pregnancy prevention.
The cheat Sheet
Common brand names
Nexplanon & Implanon
Preventing pregnancy
Over 99% effective
Starting on this method
You’ll need a prescription, and the implant has to be inserted by a trained doctor or nurse.
Lasts for
If it’s done in the first five days of your period, you’re protected right away. Otherwise, you’ll need to use backup for 7 days while it kicks in. Stays in for 3 years, then it needs to be replaced to keep working. Can be removed at any time.
Hormones
Yes, contains synthetic hormone, etonogestrel - a type of progestogen.
STIs
No protection against STIs
Periods
Your period may change, some people have lighter, more regular bleeding, while others may experience spotting or heavier flow, especially at first.
Acne/skin
Can improve and/or worsen your acne/skin
Mood/emotions
May help or affect your mood, depending on how your body reacts to the hormones.
Pregnancy after removal
Fertility usually returns quickly after removing the implant, but for some people, it can take a few months for their cycle to regulate.
Visibility
You can’t really see it, but you might be able to feel it. It doesn’t stick out or poke through, and it’s usually not visible unless someone’s really looking for it. You might notice a small mark or scar where it was inserted, but that normally fades over time.
Financial investment
Available by prescription in Australia, and may be partly covered by Medicare.
The implant is a tiny, flexible rod (matchstick-sized!) that sits just under the skin of your upper arm. It slowly releases etonogestrel, a synthetic version of the hormone progestogen, into your bloodstream over time.
Even though it’s a tiny rod just chilling in your arm, its sets off big changes in your body to prevent pregnancy working on your ovaries, cervix, and uterus like a well-organised security team.
It prevents pregnancy in three main ways:
These hormones prevent pregnancy in three main ways:
1. Thickens cervical mucus
Imagine the cervix is the entrance to a fancy garden party, and sperm are uninvited guests. Normally, the gate (cervical mucus) is open with a smooth path. But under the influence of progestogen, that path turns into a pit of quicksand; thick, dense, and nearly impossible to cross. Most sperm get stuck before they even make it to the gate. Poor things, the party is popping off!
2. Thins the uterine lining
The uterus usually fluffs up its lining like a cozy bed, getting ready to welcome a fertilised egg. The hormone in the implant strip the bed and take away the welcome mat, making it much harder for anything to settle in and stay. Because guess what, this hotel has no vacancies!
3. Stops ovulation
Think of your ovaries like a vending machine that releases one egg (snack) each month. The hormone in the implant switch off the machine, so no egg gets released. No egg means nothing for sperm to fertilise; therefore no pregnancy!
- People who want to set-and-forget their birth control for 1,095 days (that’s 3 years of peace of mind).
- Anyone looking for ultra-effective contraception without the daily, weekly, or monthly mental load.
- Those who want a hormonal option without oestrogen (aka progestin-only protection).
- It doesn’t protect against STIs, so consider pairing it with condoms if that’s a concern.
- There’s mixed evidence on whether the implant causes weight gain; some people notice changes, others don’t.
- You might feel it under the skin, but it’s discreet and not usually visible.
The not-so-fun stuff
Common side effects
Let’s be honest. No contraceptive method is perfect. And when it comes to hormonal contraception, side effects can feel like a bit of a lucky dip. What one person barely notices, another might really struggle with. Everyone responds differently - physically, emotionally, mentally and every response is valid.
We want you to have the full picture so you can make a decision that works for your body, not just what looks good on paper.
So here it is: the good, the meh, and the stuff worth keeping an eye on.
Most people adjust after 2-3 months of using the implant, but here are some side effects that tend to show up early on:
- Irregular menstrual bleeding (especially in the first 6-12 months)
- Acne or skin changes
- Headaches
- Weight gain
- Breast pain or tenderness
- Mood changes including depressed mood
- Abdominal pain
- Decreased libido
- Bruising, swelling, or pain at the insertion site - usually mild and temporary and should settle within a few days.
The Lowdown is a contraception review platform where real people share their lived experiences with different birth control methods, including the implant. We think this kind of lived experience is very helpful. It gives you a broader, more human view of what the pill is like day to day, beyond just the clinical stats.
- Emotional ups and downs or mood swings
- Irregular bleeding or spotting, especially early on
- Decreased sex drive
- Weight gain
- Skin changes
- Tender breasts
- Vaginal dryness
- Period-like cramps
Less Common But important to know
- There’s a small risk of infections at the insertion site, but this is rare and usually mild. If this does happen, it will need to be treated.
- In rare cases, the implant can be placed too deeply or migrate slightly, making it harder to feel or remove. This is why trained providers must insert it, and why some brands like Nexplanon are radio-opaque (can be seen on X-ray if needed, pretty impressive hey!).
Irregular bleeding is very common with the implant, especially in the first 6 to 12 months. It can range from barely-there spotting to full-on unpredictability, and for some people, it’s annoying enough to call it quits early. TBH, it’s the most common reason people choose to have the implant removed.
Here’s how it typically plays out:
- No bleeding at all - around 1 in 5 people
- Occasional light bleeding - around 3 in 5 people
- Frequent or prolonged bleeding - around 1 in 5 people
If your implant bends or breaks while it’s in your arm, don’t panic, it should still do its job. It’s rare, but it can happen, usually thanks to things like contact sports (thursday night boxfit classes get rowdy, it happens) or a bit too much poking and prodding (guilty).
Sometimes a broken implant can shift slightly from where it was originally placed. If anything feels off, or you’re just not sure, chat with your healthcare provider.
Sometimes, the implant can cause small, harmless ovarian cysts to form. They’re non-cancerous, usually go away on their own, and most people won’t even know they’re there. Occasionally, they can cause a bit of pelvic pain or bloating, but serious issues are rare. If anything feels off, check in with your doctor just to check.
Hormonal contraception is not a one-size-fits-all so when it comes to how your mood will be affected by synthetic hormones, it's a bit of a trial and error. If you’ve ever felt like your mental health is connected to your hormones, you’re not imagining it.
Some people using the implant report mood swings, low mood, or anxiety. Others feel no change at all, or even more emotionally steady than before. The research is mixed, but a growing number of studies suggest that people with a history of things like depression, anxiety, or PMDD may be more sensitive to hormonal shifts.
If you notice changes in your mood after getting the implant, whether that’s a subtle shift or something more significant, it’s worth tracking and bringing up with a healthcare provider. You are the expert on your body, and you deserve care that takes mental health seriously.
You’re not overreacting. You’re paying attention. And that matters. We are sending you a virtual hug right now.
If the implant fails (which is unlikely) and you do become pregnant, there's a slightly higher chance that the pregnancy could be ectopic, meaning it implants outside the uterus, usually in a fallopian tube. It’s rare, but important to know the signs: severe one-sided pain, unusual bleeding, or feeling dizzy or faint. If anything feels off, check in with your doctor, just to be safe.
Your hormones explained
Localised vs non-localised hormones
Methods like hormonal IUDs and the vaginal ring
- These are designed to release hormones directly to the uterus or cervix, with the goal of staying “local.”
- Ovulation may or may not be suppressed, depending on the method and you as a human!
- They’re often described as “low impact” but there’s some grey area to that.
Methods like the combined pill, injection and implant
- Hormones are delivered into your bloodstream and circulate throughout your entire body.
- That means they can influence your brain, breasts, skin, bones, libido, mood, appetite…pretty much everything.
- Ovulation is usually fully suppressed.
- There’s a strong potential for both physical and psychological effects, because these hormones touch every system.
Even local methods like the hormonal IUD aren’t truly local. A portion of those hormones still enter your bloodstream. And once they’re in? They’re catching an Uber straight to your central nervous system, aka your brain, which is basically a hormone sponge.
Your brain has estrogen and progesterone receptors scattered throughout:
- Amygdala (emotion)
- Hippocampus (memory)
- Prefrontal cortex (decision-making, motivation)
- Hypothalamus (hormone regulation)
- Brainstem (autonomic nervous system)
That’s a lot of big words but in other words, your brain is not just along for the ride, it’s driving the car.
If you’ve ever said:
- “I don’t feel like myself on birth control.”
- “The IUD was meant to be low-impact, but I still felt off.”
- “It helped my skin but wrecked my libido.”
- “I feel calm, but numb.”
You’re not imagining it. You’re experiencing the full-body, full-mind reality of synthetic hormones - even from methods that are “local”.
No matter how the hormones are absorbed, through your uterus, your skin, your gut, or a tiny implant in your arm, synthetic hormones affect all of you. That doesn’t make them bad. It just makes them pretty powerful.
Knowing how they work gives you the info you need to figure out what’s right for you!
Your current sitch & timing the implant insertion
If you’re not currently using any hormonal contraception
Insert the implant between day 1 to 5 of your period, this will mean you’re protected immediately after insertion.
Switching from the combined pill
Insert the implant the day after your last active pill, or at the latest, during your usual placebo break.
Switching from the vaginal ring or patch
Insert the implant on the day you remove it, or by the time your next one would’ve been due.
Switching from progestogen-only contraception (mini pill, injection, implant, or hormonal IUD)
Mini pill: You can switch any day. Just make sure the implant is inserted within 24 hours of your last pill.
Injection: Insert the implant on the day your next shot is due.
Old implant or hormonal IUD: Easy, insert the new implant the same day your old method is removed.
After having a baby, miscarriage or abortion
Speak with your doctor; they’ll help you with timing based on your situation.
What if the timing’s a bit off?
No stress, life gets in the way, and these things happen! You'll need to use backup contraception (like condoms) for 7 days after insertion just to be safe. And if the timing’s uncertain, your doctor may want to rule out pregnancy before popping the implant in.
What to expect
Getting the implant is quick, low-fuss, and over before you can say “contraception”, here’s the lowdown on insertion, removal, and keeping your arm happy after.
Insertion
It’s quick. Like, “blink and it’s done” quick. Usually under 20 minutes, tops. Your healthcare provider will numb a small spot on the inside of your upper arm (it might sting a bit) with some local anesthetic. Then, they’ll use a device to slide the implant (about the size of a matchstick) just under the skin. You might feel some pressure, but it shouldn’t hurt.
Right after your implant is inserted, your healthcare provider will ask you to feel it under your skin, just to make sure it’s in the right spot. You should be able to feel both ends of the little rod between your thumb and finger, and they’ll check too.
That said, feeling the implant isn't a foolproof way to confirm it’s there. If you can’t feel it right away, or at any point down the track, it could mean the implant wasn’t inserted properly or has gone in a little too deep. Either way, your provider can help double-check using an ultrasound or X-ray if needed.
You’ll leave with a little bandage, a bit of compression wrapping to reduce bruising.
Hot tip: Set a reminder in your phone for 3 years from now. If all things go well, 3 years will roll round and you’ll be thinking “time flies when you’re not worrying about contraception.” If that’s not the case, you can always get it removed at any time!
Removal
When it’s time to part ways (anytime within 3 years), it’s basically the reverse. Numb the area of your arm, make a tiny incision, and gently slide the implant out. If you’re keen to keep riding the implant train, they can pop a new one in during the same visit.
Aftercare
- Keep that pressure bandage on for the first 24 hours, and avoid heavy lifting with that arm.
- After 24 hours, remove the bandage, but leave the dressing on for another 2–3 days.
- Keep the area dry unless you’ve been given a waterproof dressing.
- Bruising, swelling, or tenderness are totally normal. An ice pack can help ease it.
Insertion - what’s right and what’s wrong
- Mild bruising, swelling, or tenderness around the implant site.
- A bit of pain or discomfort for a day or two.
- A small scar (usually fades over time).
- Light bleeding or spotting after insertion.
- Changes in your cycle (e.g. lighter, longer, irregular, or no periods).
- You notice a new breast lump.
- You’re experiencing heavy or ongoing vaginal bleeding that doesn’t settle.
- You feel persistent pain, swelling, or warmth in one leg (especially the calf).
- You notice yellowing of your skin or eyes (this can be a sign of jaundice).
- The area around your implant becomes red, swollen, warm, painful, or starts to ooze.
- You have pregnancy symptoms, or something just doesn’t feel right, trust your gut.
- You have sudden or intense pain in your lower abdomen.
- You can’t feel your implant anymore, or it seems to have changed shape. Try not to press or squeeze the area too much, this can occasionally cause the rod to bend or break.
You know your body best. If anything feels off, physically or emotionally, it’s absolutely okay to check in with your doctor. You're not overreacting; you're looking out for yourself.
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Pain-free, baby!
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Pain-free, baby!
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I can feel it, but it’s no biggie.
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It’s annoying, but I can tune it out.
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It’s constant and starting to wear me down.
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It’s hard to focus. I’m uncomfortable and kind of done.
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I need support — I can’t manage this on my own. Might be time to call the doctor.
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This is serious. I’m struggling to cope and thinking about urgent care.
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I can’t move or think straight. This feels emergency-level.
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The worst pain I’ve ever felt. This is an emergency. Hospital, now.
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A cute drop
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Light flow
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Heavy
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Very heavy
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Flood zone
The pain-o-metre
A lot of us downplay our pain.
Especially when it comes to periods, cramping, or anything uterus-adjacent. We’re taught to tough it out, to call it “normal,” even when it’s not. Why? Because for a very long time, the world told us to.
That’s exactly why we created this Pain-O-Metre, to help you check in with your body, validate what you’re feeling, and remind you that asking for help isn’t dramatic. It’s smart.
This scale is here to help you check in with your body - it’s not a substitute for medical advice. If you’re ever unsure, always check in with a healthcare provider.
The Blood-o-metre
This scale is a guide, not a diagnosis. Everyone’s body and baseline are different, and pain or bleeding that’s affecting your daily life, mental health, or ability to function is reason enough to check in with a medical professional.
When in doubt - Trust your gut, and seek support.
Troubleshooting the implant
For most people, it’s just a quick pinch and some pressure, thanks to the numbing injection. But yes, it can hurt a little during or after, especially if the anaesthetic doesn’t fully kick in. Some bruising and tenderness for a few days is normal.
When to check in with your doctor: If the pain is sharp, gets worse over time, or comes with swelling, redness, or signs of infection, get it checked asap. It doesn’t necessarily mean something went wrong, but it’s better to be safe.
Yes, the implant is safe to use while breastfeeding. However, a tiny amount of the hormone may pass into your breast milk, but it won’t mess with your milk supply, its quality, or your baby’s growth and development.
If you're breastfeeding and thinking about getting the implant, chat with your doctor to make sure it’s the right fit for you!
Totally fine! You can have it removed at any time by a trained healthcare provider, whether you’re switching methods, having side effects, or planning a pregnancy. Once it’s out, your fertility returns back to your normal.
As long as it was inserted correctly by a trained healthcare professional and is still within the 3-year window, you can trust that it's doing its job (go put your feet up and relax!). It's over 99% effective, and you don’t need to do anything else unless it's time for removal or replacement.
You can get back to most of your usual activities, including exercise, normally within a day or two of getting the implant. That said, it’s best to go easy on the arm where the implant was inserted for the first 24 hours. That means no heavy lifting, intense upper body workouts, or anything that puts pressure on the area.
After that, you’re good to ease back into your regular routine, as long as where it was inserted feels okay. A little bruising or tenderness is normal, so listen to your body and maybe skip the boxing class for a few days.
Where this info comes from
This page was created using guidance from trusted Australian and international health organisations, clinical guidelines, and peer-reviewed research. These sources support the medical accuracy, accessibility, and lived experience approach behind this content.
- BetterHealth Channel - contraception - implants
- Family Planning NSW - contraceptive implant
- Healthdirect Australia - contraceptive implant
- Sexual Health Victoria - contraceptive implant
- SHINE SA – Contraceptive implant (implanon)
- MSI Australia – Contraceptive implant
- Body Talk – implant (the rod)
- Nexplanon NXT - consumer medicine information
- Implanon NXT - consumer medicine information
- FSRH (Faculty of Sexual and Reproductive Healthcare, UK) - implant
- WHO – Medical Eligibility Criteria for Contraceptive Use, 5th edition
- NHS UK - contraceptive implant
- Brook - Contraceptive implant
- Planned Parenthood - birth control implant
- Mayo Clinic - contraceptive implant
- WebMD - birth control implant
- Alvergne, A., & Lummaa, V. (2010). Does the contraceptive pill alter mate choice in humans? Trends in Ecology & Evolution, 25(3), 171–179. DOI: 10.1016/j.tree.2009.08.003.
- Brønnick, M. K., Ottowitz, W. E., Pfeifer, G., & Pletzer, B. (2020). Systematic review of neuroimaging studies on hormonal contraceptives. Frontiers in Psychology, 11, 1560. DOI: 10.3389/fpsyg.2020.556577
- Lauring, J. R., Lehman, E. B., Deimling, T. A., Legro, R. S., & Chuang, C. H. (2016). Combined hormonal contraception use in reproductive-age women with contraindications to estrogen use. American Journal of Obstetrics and Gynecology, 215(3), 330.e1–330.e7. https://doi.org/10.1016/j.ajog.2016.03.047
- Pletzer, B., & Kerschbaum, H. H. (2014). 50 years of hormonal contraception—Time to find out what it does to our brain. Frontiers in Neuroscience, 8, 256. DOI: 10.3389/fnins.2014.00256
- Skovlund, C. W., Morch, L. S., Skovlund, C. W., et al. (2016). Association of hormonal contraception with depression. JAMA Psychiatry, 73(11), 1154–1162. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2552796
- World Health Organization, International Agency for Research on Cancer. (2007). Combined estrogen–progestogen contraceptives and combined estrogen–progestogen menopausal therapy (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 91). https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Combined-Estrogen--Progestogen-Contraceptives-And-Combined-Estrogen-Progestogen-Menopausal-Therapy-2007
- Otten, C. (2021). The sex ed you never had. Allen & Unwin.
- Hill, S. E. (2019). This is your brain on birth control: The surprising science of women, hormones, and the law of unintended consequences. Avery.
