Long-acting Reversible Contraception

Intrauterine Devices (IUDs) and Nexplanon Insertion and Removal

Duke Health providers place and remove long-acting, reversible contraception including intrauterine devices (IUDs) and contraceptive implants (Nexplanon). These long-acting, reversible contraceptive options are among the most effective forms of birth control and prevent pregnancy for several years. They do not affect future fertility, and they do not prevent sexually transmitted diseases.

Schedule An Appointment for IUD or Nexplanon Placement and Removal Online

Some providers perform the procedure on the day of your appointment. Other providers conduct a consultation during a first visit and then perform the procedure during the second visit. Schedule online and choose what works for you or call the number below.

Make an Appointment

or call 919-684-2471

Intrauterine Devices (IUDs)

An IUD is a small, T-shaped plastic device that is placed inside the uterus during an office visit. An IUD makes it harder for sperm to reach and fertilize an egg. There are two types: hormonal and non-hormonal IUDs. Studies show both are 99 percent effective in preventing pregnancy. How long they remain effective depends on the type of IUD you choose. Your doctor can help you determine which one is right for you.

Hormonal IUDs release a small amount of the hormone progestin, which prevents sperm from entering the uterus by thickening cervical mucous. While the hormonal IUD is in place, it can lighten, shorten, or eliminate your menstrual cycle. There are several different hormonal IUDs approved for use in the U.S.
Non-hormonal IUDs are also plastic, but they are wrapped in copper wire. They interfere with sperm movement and are as effective as hormonal IUDs. Because there are no hormones, it does not affect your menstrual cycle. Some people experience heavier and/or more painful periods with the copper IUD. Only one non-hormonal IUD is approved for use in the U.S.

Please note:

IUDs do not affect your future fertility.
IUDs do not protect against sexually transmitted diseases.
They can be removed during an office visit and should be replaced after several years of use. The timing depends on the IUD you choose.
Most insurance plans cover the placement and removal of an IUD. Check with your plan to determine your coverage.

Call for an Appointment

919-684-2471

Request an Appointment Online

Contraceptive Implants (Nexplanon)

Nexplanon is a plastic, matchstick-sized contraceptive implant that is inserted under the skin in your upper arm. Insertion takes place during an office visit, after numbing medication is applied. The implant releases the hormone progestin, which prevents sperm from entering the uterus by thickening cervical mucous. While it is in place, Nexplanon may make your menstrual cycle lighter, heavier, and unpredictable. Studies show it is up to 99 percent effective in preventing pregnancy and can remain in place for up to five years.

Please note:

Nexplanon does not affect your future fertility.
Nexplanon does not protect against sexually transmitted diseases.
The implant can be removed during an office visit and should be replaced after several years of use.
Most insurance plans cover the placement and removal of Nexplanon. Check with your plan to determine your coverage.

Preparing for Your IUD or Nexplanon Implant Visit

Avoiding Pregnancy
If you are having sex that could cause a pregnancy and are not using another method of birth control, do not have unprotected sex for at least three weeks before your appointment. If you are using another birth control method, continue using it consistently until your appointment.

Comfort Considerations
Placement of an IUD or Nexplanon can range from uncomfortable to painful, typically like bad menstrual cramps. Before your visit, ask your provider which pain control options they offer. Common options include ibuprofen or naproxen, soothing music, a heat pack, numbing medicine in the vagina or cervix, oral medications that help you relax, or IV medications for pain and relaxation (in some settings).

You may wish to take 600 to 800 mg of ibuprofen or 440 mg naproxen 30 to 60 minutes before you arrive at the clinic, if you are not allergic. Let your provider know if you've taken one of these medications.

You may want to bring someone with you to drive you home.

During Your Visit

You will meet your provider and have time to ask questions about the device and the procedure.

If you choose to move ahead, you will sign a document consenting the placement, removal or replacement of the contraceptive device. You will always have the option to change your mind or delay the procedure to another day if you aren’t ready.

IUD Insertion

You may need to provide a urine sample for a pregnancy test on the day of your IUD placement.
Your doctor will perform a pelvic exam.
Your doctor will access your cervix. The IUD is inserted through the cervix.
Depending on the IUD you choose, the contraceptive may be effective immediately or within 7 days.
You may experience cramping so it’s a good idea to rest after IUD placement.
Your provider will talk to you about checking the IUD strings to ensure the IUD remains in place.
Bleeding and cramping are common after an IUD insertion, removal, or replacement. Many patients find a heating pad helpful. Ask your provider about using over-the-counter medications like ibuprofen or naproxen to help with cramping and pain.

Nexplanon Insertion

You may need to provide a urine sample for a pregnancy test on the day of your implant placement.
Your doctor will clean your arm and inject a numbing solution.
The implant is inserted through a small incision
The area is covered with a bandage that must remain in place for several days.
The contraceptive is effective within 7 days.

Best Hospital for Obstetrics and Gynecology in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. That is why our obstetrics and gynecology program is nationally ranked and is the highest-ranked program in North Carolina, according to U.S. News & World Report for 2025-2026.

Patient Resources

Bedsider.org

This page was medically reviewed on 03/31/2025 by

Jonas Swartz, MD, MPH | Obstetrician and Gynecologist