Understanding the Primary Side Effect of Nexplanon
While Nexplanon is a highly effective, long-acting reversible contraceptive (LARC), it's important to understand its potential side effects. The single most reported side effect that leads to a patient discontinuing its use is a change in menstrual bleeding patterns. Unlike other hormonal birth control methods that often result in predictable cycles, the progestin-only hormone (etonogestrel) in Nexplanon can cause a variety of menstrual irregularities.
These changes can include:
- Irregular and Unpredictable Spotting: Many users experience light, intermittent bleeding between periods, especially during the first 6 to 12 months.
- Heavier or More Frequent Periods: Some women may notice that their periods become longer or heavier than usual.
- No Period at All (Amenorrhea): A significant number of users, approximately 1 in 5, find that their periods stop completely while on Nexplanon, which many consider a positive side effect.
- Lighter or Shorter Periods: For many, periods become lighter and less painful over time.
The unpredictability of bleeding patterns is often cited as the main reason for removing the implant. It's a key consideration for anyone exploring this birth control option.
Other Common Nexplanon Side Effects
Beyond menstrual irregularities, several other side effects are commonly reported by Nexplanon users. These are often related to hormonal fluctuations and can vary in intensity and duration for each individual.
Other Frequently Reported Side Effects
- Headaches: Affecting up to 25% of users in clinical trials, headaches are a common complaint. They can range from mild to severe and may occur more frequently at the beginning of use.
- Weight Gain: In clinical trials, weight gain was reported by about 14% of participants, with users gaining an average of 2.8 to 3.7 pounds over one to two years. While this is a commonly reported issue, research is mixed on whether the implant is the direct cause.
- Mood Swings: Hormonal changes can influence mood, and a small percentage of users report mood swings, depression, or increased anxiety. If you have a history of depression, a healthcare provider will monitor you more closely.
- Acne: Some individuals may experience an increase in acne breakouts, which is another result of hormonal shifts.
- Breast Pain: Tenderness or pain in the breasts is another possible side effect.
- Insertion Site Reactions: Minor, temporary issues like pain, bruising, or swelling at the insertion site are common immediately after the procedure.
Comparison of Side Effects: Nexplanon vs. Other Methods
Choosing a contraceptive involves weighing the pros and cons of different methods. The table below provides a general comparison of common side effects for Nexplanon, oral contraceptives (pills), and hormonal IUDs, based on information from clinical studies.
| Side Effect | Nexplanon (Progestin Only) | Oral Contraceptives (Combined Hormones) | Hormonal IUDs (Progestin Only) |
|---|---|---|---|
| Bleeding Patterns | Highly unpredictable; can range from frequent spotting to no period at all. | Predictable and regular periods are typical; breakthrough bleeding is possible, especially at first. | Lighter or no periods are common, though spotting can occur in the first few months. |
| Weight Gain | Reported by ~14% of users in trials; average gain is modest, but may be bothersome for some. | Conflicting evidence on significant weight gain; not a major factor for most. | Not typically associated with significant systemic weight gain. |
| Mood Changes | Reported by some users; less common as a reason for discontinuation than bleeding issues. | Can occur in some individuals; may be managed by switching pill formulations. | Some users report mood changes, but it is not as common as with systemic methods. |
| Headaches | Reported by up to 25% of users in clinical trials. | Possible, especially in the first few months; can be managed or resolved by changing pill. | Can be a side effect, though typically less common than with systemic methods. |
| Convenience | Set it and forget it for up to three years. | Must be taken daily; requires adherence. | Set it and forget it for several years, depending on the type. |
How Long Do Side Effects of Nexplanon Last?
For many people, the most bothersome side effects of Nexplanon subside within the first three to six months as their body adjusts to the hormone. This is particularly true for symptoms like headaches and nausea. However, menstrual bleeding patterns and weight changes may persist for as long as the implant is in place. If side effects are persistent or severe, a healthcare provider might recommend removal. Once the implant is removed, hormone levels typically return to normal within a week, and any related side effects should fade.
Key Factors to Discuss with a Healthcare Provider
Before deciding on Nexplanon, it's crucial to have a comprehensive discussion with your doctor. They will review your medical history to ensure it's a safe option and help you set expectations for potential side effects. Things to consider include:
- Medical Conditions: Your doctor will need to know about any history of blood clots, liver disease, cancer (especially breast cancer), high blood pressure, or diabetes.
- Current Medications: Certain medications, including some antibiotics and supplements like St. John's wort, can reduce the effectiveness of Nexplanon.
- Lifestyle Factors: Smokers are at a higher risk of serious blood clots and should discuss this with their provider.
Conclusion
While Nexplanon is an extremely effective contraceptive, the most significant side effect for users is the high likelihood of changes to their menstrual bleeding patterns. While other side effects like headaches, weight gain, and mood swings are also common, irregular bleeding is the top reason for discontinuation. Most side effects are temporary and improve as the body adjusts, but menstrual changes can be long-lasting. Ultimately, the decision to use Nexplanon depends on an individual's tolerance for potential side effects versus the convenience and high effectiveness of the implant. Consulting a healthcare provider is the best way to determine if this birth control option is right for you.
Risks of Nexplanon
It is vital for patients to be aware of the more serious, though rare, risks associated with Nexplanon. These include:
- Blood Clots: While less clear than with combination pills, the use of progestin-only contraception like Nexplanon may slightly increase the risk of blood clots, especially in those with other risk factors.
- Ectopic Pregnancy: Though Nexplanon is highly effective, if a pregnancy does occur, there is a slightly higher risk that it will be ectopic.
- Insertion and Removal Complications: In very rare cases, incorrect insertion can lead to the implant moving, nerve damage, or difficulty during removal.
- Ovarian Cysts: Small, benign cysts on the ovaries can develop, though they often resolve on their own.
What to Do If You Experience Side Effects
If you find the side effects of Nexplanon bothersome, it is important to communicate with your doctor. Many side effects can be managed with other medications or by giving your body more time to adjust. If the effects are intolerable, your provider can discuss alternative birth control methods and safely remove the implant. You can learn more about managing side effects and finding the right birth control for you from reputable sources like Planned Parenthood.
