Nexplanon is an etonogestrel implant that prevents ovulation, and in turn, prevent pregnancy. While used by women as a form of contraception, it is known to have unfavorable side effects on the menstrual cycle.
What is Nexplanon?
Nexplanon is an implant, usually implanted into the skin of the upper arm, and is used as a form of medicinal contraception that releases the hormone etonogestrel. This hormone effectively prevents the release of an egg from the ovary in order to prevent pregnancy from happening, and is 99% effective.
Nexplanon can also cause changes in the cervical mucus and uterine lining, which can make it more difficult for sperm to reach the uterus and decreasing chances of a fertilized egg attaching to the uterus. Nexplanon is implanted and the hormone is released gradually into the body, and it can be used for up to 3 years as contraception in the body.
The timing of the insertion of nexplanon is important. Nexplanon should be inserted within the first seven days of the menstrual cycle or while on oral contraceptives. You must do a routine pregnancy test before insertion to ensure that you are not pregnant.
MECHANISM OF ACTION
Nexplanon is a single rod contraceptive implant with measurements 40 mm length and 2 mm diameter. It contains 68 mg of etonogestrel which is dispersed in an ethylene vinyl acetate membrane. Nexplanon works by suppressing ovulation in every menstrual cycle for three years.
This mechanism of preventing pregnancy is highly effective because it is a low dose of hormone that is beneficial in preventing the release of an egg from the ovary.
HEALTH BENEFITS OF NEXPLANON
There are many health benefits of Nexplanon as an effective birth control implant. It consists of hormone which facilitates women undergoing certain gynecological or general health conditions who wish to adopt an effective birth control method. Some of the vital health benefits of Nexplanon are as follows:
- Nexplanon – long-lasting birth control
- No stress of mission birth control dosage
- Lighter and comfortable periods
These benefits may vary in women such as light or heavy bleeding due to clinical conditions or being obese.
THINGS TO CONSIDER BEFORE NEXOPLANON IMPLANT
There are several medical conditions in which it is necessary to avoid Nexoplanon Implant. These clinical conditions are as follows:
- Cardiovascular disease
- Chronic Vaginal infection with bleeding
- Heavy menstrual bleeding
- Highly hypertensive
- Cancer and Liver cirrhosis
- Severe migraine attacks
- Smoking and drinking (above 35 years)
- History of cardiac arrest
- History of viral infection like Hepatitis C
Nexplanon as a drug can increase the chances of developing increased blood clots that’s why it is highly recommended to share your clinical history with your health care professional to avoid further complications.
What Are Its Side Effects?
The most common side effects of nexplanon are the ones that affect your menstrual cycle. Nexplanon can cause a change in the pattern of your menstrual bleeding during your period.
Menstrual bleeding patterns may suddenly occur more frequently, with longer or shorter bleeding experienced during your period or no bleeding occurring at all. The time between your menstrual periods may also vary and change, and you may experience some spotting in between periods as well.
For some women, menstrual bleeding might stop altogether. This is also nothing to be concerned about. In this case, the ovaries are resting and abstaining from releasing an egg every month, keeping the uterine lining thin.
There are other common side effects related to your menstrual cycle that you might experience if you use nexplanon. Apart from the changes in menstrual bleeding patterns, nexplanon can cause mood swings, weight gain, headaches, acne, and depression. Nexplanon can, in effect, amplify symptoms of PMS and your menstrual period by making their symptoms worse. You may also experience stomach pain, breast tenderness, and vaginal itching or discharge.
Nexplanon can also cause more painful periods, and affect the reproductive organs as well. Vaginitis is another known side effect that causes the vagina to become inflamed. There is also a chance of ovarian cysts developing, but this may be treated. Women also sometimes experience pain, bruising, or swelling at the site of the insertion. Many women choose to stop using the implant because of these changes. Once the implant is removed, your menstrual cycles should return to the way they were before.
While menstrual changes are relatively common among women using the hormonal implants, every woman’s body operates differently and it’s also perfectly normal to not experience any irregular changes either. Every woman is different, and it all depends on each individual.
So Are There Any Risks?
There is the risk of issues surrounding the insertion of the implant and its removal. If the implant is inserted improperly you may be able to become pregnant. Locating and removing the implant can even be difficult if the implant is not inserted correctly.
It is also advised that if you become pregnant while using nexplanon, there is a higher risk of the pregnancy becoming ectopic as a result. Other than that, experiencing differences in the pattern of your menstrual cycle is normal while using nexplanon, although it is important to keep an eye on the side effects to watch out for anything that might indicate a possible pregnancy or a serious reaction.
Women shouldn’t go ahead with the nexplanon implant if they are already experiencing abnormal vaginal bleeding. If your menstrual bleeding becomes severely heavy and prolonged, you should seek a doctor’s advice.
References:
- Mommers, E., Blum, G. F., Gent, T. G., Peters, K. P., Sørdal, T. S., & Marintcheva-Petrova, M. (2012). Nexplanon, a radiopaque etonogestrel implant in combination with a next-generation applicator: 3-year results of a noncomparative multicenter trial. American journal of obstetrics and gynecology, 207(5), 388-e1.
- Praet, C., & D’Oca, K. (2014). Cost-benefit model of varying Nexplanon and other long-acting reversible contraceptive (LARC) methods uptake compared to the oral contraceptive pill: UK perspective. Value Health, 17, A508.
- Chevreau, J., Krief, D., Arab, O. A., Zitoun, M., Foulon, A., Sergent, F., & Gondry, J. (2018). Factors associated with removal difficulties of etonogestrel-containing contraceptive implants (Nexplanon®). European Journal of Obstetrics & Gynecology and Reproductive Biology, 224, 81-84.
- Braun-Courville, D. K., & Romano, M. E. (2016). Patterns of Contraceptive Implant Use in a General Adolescent Medicine Clinic Population. Journal of Adolescent Health, 58(2), S79.
- Romano, M. E., & Braun-Corville, D. K. (2016). Patterns of Contraceptive Implant Use in a General Adolescent Medicine Clinic. Journal of Pediatric and Adolescent Gynecology, 29(2), 171.
- Dewitt, J. D., Ahmad, N., Hoffman, S. M., & Edmonds, B. T. (2018). Understanding Long-acting Reversible Contraceptive Decision-making in the Immediate Postpartum Period [10g]. Obstetrics & Gynecology, 131, 77S.
Partridge, R., & Bush, J. (2013). Infections post-Nexplanon® insertion. J Fam Plann Reprod Health Care, 39(4), 309-310.
Hi Daniela I removed my explanon about two months ago. I just got my period but its been really heavy for two days and my ovaries hurt I been bleeding down and chunks of blood is this normal often a removing it.. Should I go to my doctor? Also I have no been using protection because me amd my husband wants to have another baby.
HI Janeth, it could be normal. Sometimes it takes a while for the body to get back on it’s own rhythm so to speak. If this is your first one I wouldn’t be too worried unless it’s causing you to feel lightheaded, passing out etc. But it sounds to be just a very heavy flow (some deal with flow like that on a regular basis). You can get pregnant at any time considering you aren’t on any protection. I would consider using the calculator also on our site to see when your most likely fertile period is, based on your previous cycle length (at least that’s where I would start right now). Good luck with getting pregnant! And here is the link: https://womanjunction.com
Thank you so much for your response! I will look into the calculator.
Hi . I got my nexplanon inserted on 22 January.
My first period started on 10 February for two weeks. While I had headaches also for two weeks and mood changing.to worse. Weight again.
In this month’s March I had painful period without bleeding for 5 days .I scared about all this side effects because I h had asthma and I use strong inhaler .
I want to know about pain of period is caused by nexplanon or another cause.
Hi Linda, these sound like side effects of Nexplanon. Many people who have it and get it out are taking it out because of issues with their period, significant mood changes, etc. I would recommend giving it about 3-4 months hopefully to let your body adjust, but if it doesn’t I might consider a different form of birth control. Good luck!
Had my implant for 3 years, onJan 4th had a new one put in. Didn’t get my period in Jan, Feb but here we are in march and I am having spotting and terrible cramps. Never had this happen before. Could this be from the Newest Nexplanon.
Hi Becca, it definitely could be from your newest implant. Some people find cramping and irregular bleeding par for the course with Nexplanon. i would give it a few months to regulate and if it doesn’t or it’s a significant hinderance to you, discuss other options with your doctor.
I just started using nexplanon about week ago, and i supposed to start my period on the 20thof this month? But after I started in implant i used birth control pills.
Hi Raizel, Why are you taking two forms of birth control? That could affect when your period starts.
Hi my name is Megan. I have had the implant for 4 years now. And I have always had my period every other month. Then, Nov. And Dec 2017 I had a period twice in one month for 2018 I have not had one. Could the implant just be working now or is there any concerns I need to know.
HI Megan, well the implant is only good for 4 years, so if you have missed your period I would recommend getting a pregnancy test and also asking your doctor for your next choice in birth control.
I have had Nexplanon for about 5 months now and my doctor said that my period should regulate within 3 to 6 months, but it seems to just be getting worse. When I first started my period it would last for two weeks long and then I would be done for two weeks and then start again for another two weeks. Well now my period is still two weeks long but I’m only off my period for 1 week. Should I call my doctor because it’s not regulating and I just want to have a normal period again?
Hi Aleesa, I would recommend calling your doctor. Most people who have their Nexplanon removed do so because of heavier and unpredictable periods. If you aren’t comfortable I would recommend finding a different method.
I got the Nexplanon implant a year ago. For the first few months I was taking additional contraceptives as I was experiencing constant spotting as well as periods, and once my hormones levelled out after about 4/5 months I started getting my regular periods again.
I’ve just passed the year mark but I’m now on Day 43 of my cycle with no period. I took a test a few days ago which came up negative, but I’m not sure if I could still be pregnant or if this is just a side effect now that the implant has been in for a year? I’m quite scared I might be pregnant, not sure if I should do another test?
Hi Amy, it could be normal for you to actually stop having your period. Nexplanon affects and prevents ovulation and the buildup of the uterine wall, so not having your period might not necessarily mean that you are pregnant. I would personally take another test just to be sure, but you might experience this again in the future as well.
Hi i have the nexplanon and hav not had a period for almost 4 months should i be worried
Hi Rosario, without letting up? Generally if you are having a period for that long I would make an appointment with the doctor. One of the things that they say is that if you have it abnormally long, you should be seen, it could be an adverse reaction to Nexplanon.
I’ve had nexplanon for almost a year now and my most recent period has been extremely long- I’m currently on day 30. For reference, my periods before nexplanon were around 5 days and after nexplanon have been around 15 days. Is this month long period a cause for concern? Not sure if it’s just a nexplanon effect or something more serious.
Hi Wren, I would consult your doctor on this one. 30 days seems like an extended amount of time to be bleeding, and that seems to be the number one reason some people get theirs removed. One of the “consult your doctor” issues is heavy and prolonged bleeding.
Is it safe to have unprotected sex after period even though it’s been a couple of months since I’ve gotten the implant? My husband and I are scared to get pregnant so I make him pull out😔
Hello Kay, if you have an implant to prevent against pregnancy then there should be no need for the withdrawal method.
So I still have my periods but, when they stop and I have intercourse my period comes right the next day again. Is this normal?
Hello Katie, no this is not. Read the below link:
https://womanjunction.com/bleeding-sex-heres-need-know/
I have had the implant for 5 years now, I’d say for the first 3 years or so didn’t have periods, and then around a year and a half ago I started having them. They seem to be lasting longer and longer, right now I am on day 18 of being on my period. Is there any explanation to the sudden change in behaviour?
Hi Helen, that could be a potential serious side effect, especially with a sudden change. I would contact your doctor.
So i got the nexplanon inserted september 2 , 2017 and my cycle came on the following day, and has been on for 5 almost 6 months now . I just want to know when will it go off , or how long will it stay on , do i need to contact my doctor because i feel like it has been on way to long and its starting to get uncomfortable \.
Hi there Latajhia, birth control affects every female different. Some females bleed straight through out being on a certain form of birth control. If this persists, discuss with your doctor a better form of birth control that works for you.
How long does it take to get your period back after you get the implant removed? I had my implant for three years and never had periods. Now I’ve had it out for two months and my period still has not returned.
Hi Brittany, is there any way that you could be pregnant? Did you take a test? Just because you didn’t get your period doens’t mean that you coulnd’t have actually conceived the first time you ovulated. I would take a test and if not it could be your hormones evening out but you should have had one at this point. Give your doctor a call and discuss it with them.
Hi Daniela, thank you for responding. Yes, I have taken two tests. I took one last month and one this month. Both were negative.
I got my nexplanon inserted on the 12th of this month & I normally start my menstrual cycle on the 20th every month. I didn’t start it at all this month ( thank god I was hoping I wouldn’t, but I know it’s still possible ). Ever since the middle of the day on the 20th I started feeling gassy pains in my stomach & they are on & off pains I have especially been getting those pains really bad after I eat anything.. (they aren’t like cramp pains) do you know why this could be? Does it have something to do with my hormones getting used to the nexplanon? If so could these pains happen every month when I’m supposed to have my period or will they eventually stop after the first few months? Any information could help, if you’ve heard of this happening to other women that have experienced their first period like this while recently getting the nexplanon? I’m not too worried about this I would just like to know a little more information on it because I’ve searched everywhere online to find answers for this uncomfortable feeling. Like I said any information you have about this can help a lot, thanks in advance!
Hi Wendi, after doing a bit of research, there have been plenty of people who have abdominal pains and period pains when they should be getting their period. Nexplanaon itself lists abdominal pain and bloating as one of the side effects of the medication. While you could get use to it, your body might still stimulate you having those pains. Some depict a lot of other side effects such as mood swings, weight gain, periods that are irregular and heavy. But at this point I would just monitor it. So it is a side effect of the medication and is normal. If you do however have severe pain or swelling in your abdomen, contact your doctor.
How long dose it take to start missing with your period i got mine put in on the 13 of this month and was supposed to start my period on the 15 of this month
Hi Margare, The changes in your period can start within the first cycle. As long as your tests are negative then you should be good to go, although there are always exceptions.