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Nexplanon Side Effects: What are they and can they be Avoided?

Nexplanon Side Effects: What are they and can they be Avoided?

Women who want to prevent pregnancy but would prefer not to take an oral contraceptive every day have more options now than ever before. Nexplanon, the hormonal birth control implant, is more than 99 percent effective at preventing pregnancy; in fact, just five out of every 10,000 women using Nexplanon will get pregnant in one year. Nexplanon can prevent pregnancy for up to five years, and there’s no risk of forgetting to take it or using it incorrectly. An estimated 10.3 percent of women between the ages of 15 and 49 use long-acting reversible contraception, such as intrauterine devices or contraceptive implants like Nexplanon, and while these types of hormonal contraception are popular, they are associated with some unpleasant side effects. What are the side effects of Nexplanon and can they be avoided?

What is Nexplanon?

Nexplanon is a long-lasting form of hormonal birth control that can provide up to three years of pregnancy prevention. Nexplanon, which is also sold under the generic name etonogestrel implant, is a prescription medication that comes in the form of a small, flexible, thin implant that is placed in the skin of the upper arm by a healthcare provider. The medication is more than 99 percent effective at preventing pregnancy and does not need to be changed on a daily, weekly, or monthly basis. Nexplanon does not contain any estrogen and instead mimics a hormone that is naturally produced in the body.

How does Nexplanon work?

Nexplanon uses hormones to prevent pregnancy in three ways. First, the hormones prevent the ovaries from developing and releasing an egg. The hormones also cause the cervical mucus to thicken, which helps prevent sperm from reaching an egg in the event that one is released. Finally, Nexplanon also causes the lining of the uterus to thin, which makes it less likely that a fertilized egg can attach to the uterus, causing pregnancy. 

What are the side effects of Nexplanon?

Nexplanon is associated with common side effects, infrequent side effects, and rare side effects that are both mild and severe in expression. Common side effects linked to Nexplanon generally do not require medical attention and tend to lessen or disappear as a patient’s body adjusts to the implant. Common side effects associated with Nexplanon that tend to have a mild expression include:

  • Breast tenderness
  • Generalized weakness
  • Infection or inflammation of the vagina
  • Reactions at the site of the implant
  • Weight gain
  • Changes in appetite
  • Headache
  • Intense abdominal pain
  • Visible water retention 
  • Weight loss

Common side effects associated with Nexplanon that tend to have a severe expression include:

  • Bleeding not related to menstrual period
  • Irregular periods

Infrequent side effects that are associated with a mild expression include:

  • Problems with menstrual periods
  • Acne
  • Diarrhea
  • Dizziness
  • Flu-like symptoms
  • Nausea
  • Throat irritation
  • Absence of menstrual periods
  • Backache
  • Discharge of fluid from the cervix
  • Drowsiness
  • Itching
  • Pain with menstruation
  • Vaginal discharge

Infrequent side effects associated with Nexplanon that tend to be more severe include:

  • Hypersensitive reactions to a drug
  • Mood changes

Rare side effects associated with Nexplanon that typically have a mild expression include:

  • Changes in vision
  • Migraine headaches
  • Change in libido
  • Chest discomfort
  • Difficult or painful urination
  • Ectropion of the cervix
  • Fever
  • Hair loss
  • Hives
  • Itching in the genital area
  • Muscle pain
  • Pain
  • Seborrhea
  • Urinary tract infection
  • Water retention
  • Feelings of pins and needles on the skin
  • Stuffy or runny nose
  • Production of breastmilk when not pregnant or nursing
  • Constipation
  • Difficulty sleeping
  • Enlarged breasts
  • Gas
  • Growth of hair on parts of the body that normally do not have hair
  • Inflammation of the sinus tissue
  • Low energy
  • Nervousness
  • Pain in the muscles or bones
  • Temporary redness of the face or neck
  • Vomiting
  • Yellow or brown patches on the skin

Other side effects that may occur while taking Nexplanon can be serious and require immediate medical attention. Talk to your healthcare professional if you experience any of the following rare side effects while taking Nexplanon:

  • Blockage in the gallbladder
  • Blood clot
  • Significant allergic reaction (anaphylaxis)
  • Stroke
  • Yellowing of the eyes or skin (jaundice)
  • Depression
  • Migration of the implant
  • Thrombophlebitis, an inflamed vein due to a blood clot
  • Blockage of the bile duct
  • Pulmonary embolism (blood clot in the lung)
  • Skin rash
  • Angioedema
  • Ovarian cyst
  • Hepatitis, or inflammation of the liver
  • Pneumonia with a high number of eosinophil white blood cells

Can the side effects of Nexplanon be prevented or avoided?

Although many women want to prevent pregnancy or address other issues that can benefit from hormone therapy, some women stop using hormonal contraceptives like Nexplanon because of the side effects. It appears that many of the side effects caused by hormonal contraceptives are nutritionally linked; the  World Health Organization (WHO) has stated that hormonal contraceptives such as Nexplanon can contribute to nutritional deficiencies of vitamins and minerals such as  folic acid, magnesium, selenium, zinc, and vitamins B2, B6, B12, C, and E. The nutritional deficiencies caused by hormonal contraceptives like Nexplanon have been linked to common side effects like depression, and low folate levels may prevent women from responding to treatment with antidepressants compared to people with high folate levels. Other common side effects of hormonal contraceptives, such as headaches, fatigue, low libido, weight gain, and difficulty sleeping may also be caused by nutritional deficiencies resulting from the hormones contained in the medication.

The nutritional deficiencies caused by some forms of hormonal contraceptives, like Nexplanon, can be addressed with a specially formulated dietary supplement, which helps support hormone balance and mitigate side effects. Correcting the nutritional deficiencies caused by hormonal contraceptives can help to lower the frequency and severity of side effects like low libido, weight gain, depression, mood swings, and headaches. With adequate nutritional support, some women may be able to avoid side effects from Nexplanon entirely.

Are there any risks associated with Nexplanon?

Among the most common risks associated with Nexplanon are potential problems with insertion or removal of the implant. If the implant is placed improperly, women may not be protected against pregnancy. Women should be able to feel the implant under the skin to ensure proper placement. Removal of the implant can be complicated if the implant has moved after placement, sometimes resulting in surgery or special procedures to remove it. In rare instances, the implant has been found in the pulmonary artery of some patients. 

Like other forms of hormonal contraception, there is a higher risk of serious cardiovascular events in women who smoke while using Nexplanon. Stroke, blood clots, heart attack, and high blood pressure are examples of the types of cardiovascular events that are more likely to occur in women who smoke while using Nexplanon. As the age of the woman and the number of cigarettes smoked increases, the corresponding risk of experiencing cardiovascular issues also increases. Although smoking while using Nexplanon is to be avoided by women of all ages, women ages 35 and older are considered to be at especially high risk.

Hormonal forms of birth control cause an increased risk of experiencing blood clots, which can be life threatening; women with a history of blood clots or blood clotting disorders should discuss their medical history with their healthcare provider before using a hormonal contraceptive like Nexplanon. Women should be sure to give their doctor a complete medical history and a comprehensive list of all prescription medications, over the counter medications, vitamins, supplements, and herbs that they are taking in order to prevent any potential drug interactions.

Sources:

https://www.nexplanon.com 

https://www.plannedparenthood.org/learn/birth-control/birth-control-implant-nexplanon/nexplanon-side-effects 

https://www.plannedparenthood.org/learn/birth-control/birth-control-implant-nexplanon/what-are-the-disadvantages-of-birth-control-implant 

https://www.webmd.com/drugs/2/drug-156597/nexplanon-subdermal/details 

https://www.webmd.com/drugs/2/drug-156597/nexplanon-subdermal/details/list-sideeffects 

https://www.cdc.gov/nchs/fastats/contraceptive.htm