Can Nexplanon Cause Weight Gain? Plus, 5 More Frequently Asked Questions

Nexplanon (etonogestrel) is a birth control implant that’s placed under the skin in your upper arm. It’s one of the most effective birth control methods — 99.95% effective, in fact. The Nexplanon implant can be placed quickly by a gynecologist or another reproductive healthcare professional. Once inserted, it works without you having to take a pill every day.

Many factors can help you decide if Nexplanon is a good fit for you. Ease of use and effectiveness are often top of mind. But whether Nexplanon can cause weight gain is another common question.

Below, we’ll answer six frequently asked questions about Nexplanon. That way, you can make an informed decision about the birth control implant.

1. Can Nexplanon cause weight gain?

Experts aren’t sure whether Nexplanon causes weight gain. During the implant’s initial clinical trials, about 14% of study participants using Nexplanon reported weight gain. But since then, other studies have found the implant doesn’t cause significant weight changes.

A 2019 study looked at 197 adolescent girls and young women. It found that those using Nexplanon gained similar amounts of weight as those who didn’t use it.

A 2016 review of studies found that most progestin-only birth controls (including Nexplanon) didn’t cause significant weight gain. On average, women gained less than 5 lbs after 6 to 12 months of use.

Contact your reproductive health team if you gain an amount of weight you’re uncomfortable with while using Nexplanon. There are several other birth control options to try. Many don’t require you to take a pill every day. It’s common to try a few types of birth control before finding one that works best for you.

Nexplanon Implants: The Birth Control Implant that Goes in Your Arm

Written by Christina Aungst, PharmD

2. When does Nexplanon stop working?

The FDA has found that Nexplanon works effectively for up to 3 years. You can have Nexplanon removed before then if you want to become pregnant, don’t like the side effects, or change your mind.

What happens if you don’t remove Nexplanon after 3 years?

In short, Nexplanon may not be as effective after 3 years.

Some studies have shown that Nexplanon may continue to work for up to 5 years. Keep in mind that the implant hasn’t been extensively studied to use this way. So there may be a higher chance of unintended pregnancy if you don’t replace it on time. Unless your reproductive care team tells you otherwise, it’s recommended to remove or replace Nexplanon after 3 years.

3. How does Nexplanon work?

The Nexplanon implant slowly releases a progestin hormone called etonogestrel. A progestin is a lab-made version of the sex hormone progesterone.

Once inserted, Nexplanon works to prevent pregnancy in three ways:

• By preventing ovulation (the release of an egg): No ovulation means there’s no egg present to be fertilized by sperm.

• By thickening cervical mucus: This is the fluid around the opening to your uterus. Thicker cervical mucus can trap sperm and make it difficult for them to reach an egg to fertilize it.

• By thinning the lining of the uterus: This helps prevent implantation of a fertilized egg if the first two actions fail.

Nexplanon’s effects aren’t permanent. They stop once you remove the implant.

Good to know: Nexplanon doesn’t protect against sexually transmitted infections. It’s recommended to use barrier methods of protection, such as condoms, for this.

4. How long does Nexplanon take to work?

It takes 7 days for Nexplanon to start working. During this time, you should use a barrier method of protection.

There may be times when you don’t need a back-up method. For example, you may not need back-up protection if you started menstruating less than 5 days before insertion. But you should check with your reproductive care team to see if this applies to you. When in doubt, it’s best to use back-up protection for 7 days after having Nexplanon inserted.

5. Can Nexplanon cause infertility?

Nexplanon isn’t known to cause infertility. In fact, many women return to normal fertility very quickly after having it removed if they don’t switch to a different hormonal birth control.

In one study, about 90% of participants reported that their periods had returned to normal within 3 months of the implant’s removal. Another study found that some women got pregnant within 2 weeks after having Nexplanon removed.

So if you’re having Nexplanon removed but not trying to get pregnant, it’s a good idea to switch to another birth control method right away.

6. How much does Nexplanon cost?

If you have health insurance, the cost of the implant and the insertion procedure is likely to be fully covered under the Affordable Care Act.

If you’re uninsured, the implant may cost about $1,100. Your medical care team may also charge fees for inserting and removing it. Check with your healthcare team to see how much they charge for the two procedures.

There are other options for helping with the cost of birth control. Try calling a women’s health clinic or a family planning center. They may charge less or offer other resources.

Why trust our experts?

Written by:

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP, has over a decade of experience as a pharmacist, professor, and researcher. She was a full-time clinical professor in the pharmacy practice department at D’Youville School of Pharmacy before subsequently joining the faculty of the pharmacy practice department at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Our editorial standards

Meet our experts