What to do for pain at the Nexplanon (etonogestrel implant) insertion site?

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Last updated: May 8, 2025View editorial policy

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From the Guidelines

If you're experiencing pain where your Nexplanon implant was inserted, try taking over-the-counter pain relievers like ibuprofen (Advil, Motrin) 400-600mg or acetaminophen (Tylenol) 500-1000mg every 6-8 hours as needed, as recommended for pain management in various clinical scenarios 1. When managing pain after the insertion of Nexplanon, it's essential to consider the principles of pain management discussed in the context of pregnancy and postpartum care, although the specific scenario of Nexplanon insertion is not directly addressed in the provided evidence 1. Key points to consider include:

  • Applying a cold compress to the area for 15-20 minutes several times daily for the first 48 hours to reduce swelling and discomfort.
  • Keeping the insertion site clean and dry.
  • Avoiding heavy lifting or strenuous activity with that arm for a few days. Some mild pain, bruising, and swelling are normal for 1-3 days after insertion. However, you should contact your healthcare provider if you experience:
  • Severe pain that doesn't improve with medication.
  • Increasing redness, warmth, pus, fever.
  • The implant appearing to be coming out.
  • Pain persists beyond 3-5 days. These symptoms could indicate infection or improper placement. The pain typically occurs because the insertion process creates minor tissue trauma and inflammation, which should resolve as your body heals, similar to other minor surgical procedures discussed in the context of pain management 1.

From the Research

Pain after Nexplanon Insertion

Pain after Nexplanon insertion is a common complaint, but the provided studies do not directly address this issue. However, we can look at some general information about pain management and infection treatment that might be relevant.

Pain Management

  • Ibuprofen has been shown to be effective in reducing pain and inflammation in various conditions, such as urinary tract infections 2 and experimental pneumococcal acute otitis media 3.
  • In the study on uncomplicated urinary tract infections, ibuprofen was used as an initial treatment to reduce the need for antibiotics 2.
  • Another study found that ibuprofen combined with antibiotics improved the outcome of experimental pneumococcal acute otitis media 3.

Infection Treatment

  • The study on common bacterial and viral infections in pregnancy discusses the use of various antibiotics, including β-lactams, macrolides, and vancomycin, to treat infections such as urinary tract infections, pelvic inflammatory disease, and gonococcal infections 4.
  • Another study found that levofloxacin or gonadotropin-releasing hormone agonist treatment decreased intrauterine microbial colonization in human endometriosis 5.
  • Intrapartum antibiotic exposure has been associated with an increased risk of immune-related diseases in childhood, highlighting the importance of careful consideration when using antibiotics 6.

Nexplanon-Related Pain

While the provided studies do not specifically address pain after Nexplanon insertion, they suggest that pain management and infection treatment are crucial aspects of patient care. If you are experiencing pain after Nexplanon insertion, it is essential to consult with your healthcare provider to determine the best course of action. They can assess your individual situation and provide guidance on pain management and infection prevention.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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