From the Guidelines
Nexplanon is a highly effective and convenient form of birth control that can be safely used by most women, with benefits including over 99% effectiveness and potential reduction in menstrual pain and heavy bleeding, but it is essential to weigh these benefits against potential risks and consider individual patient factors, as noted in the most recent guidelines 1.
Benefits of Nexplanon
- Highly effective birth control with over 99% effectiveness
- Convenience with no daily dosing
- Quick return to fertility after removal
- Potential reduction in menstrual pain and heavy bleeding
- Some women experience improvement in acne and fewer menstrual migraines
Risks and Side Effects of Nexplanon
- Irregular bleeding patterns (the most common side effect)
- Prolonged bleeding, spotting, or amenorrhea
- Headaches, mood changes, weight gain, acne, decreased libido, and breast tenderness
- Rare but serious risks include implant migration, difficult removal, infection at the insertion site, and very rarely, blood clots
Placement Procedure and Considerations
- The placement procedure involves a healthcare provider inserting the small rod-shaped implant (4 cm long) under the skin of the upper arm using local anesthesia
- The procedure takes only a few minutes, with potential bruising and soreness at the insertion site for a few days
- Nexplanon does not protect against sexually transmitted infections, so condoms are still recommended for STI prevention
- Women with certain conditions like liver disease, breast cancer, unexplained vaginal bleeding, or blood clotting disorders may not be suitable candidates for Nexplanon, as indicated by guidelines such as those from the CDC 1
Key Recommendations
- The US Selected Practice Recommendations for Contraceptive Use, 2024, suggest that Nexplanon can be started at any time, with a follow-up pregnancy test in 2-4 weeks if there is uncertainty about pregnancy status 1
- The CDC provides guidance on the use of Nexplanon in various clinical scenarios, including postpartum and postabortion care 1
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Nexplanon Placement Risks and Benefits
- The Nexplanon is a long-term reversible contraception method that exerts its effects primarily by suppressing ovulation 2.
- The most common adverse reaction to Nexplanon is a change in menstrual bleeding patterns 2.
- Nexplanon has a high effectiveness rate, with failure rates of less than 1% per year 3.
- The use of Nexplanon may be beneficial for women with certain medical conditions, such as endometriosis and premenstrual dysphoric disorder, as hormonal contraceptives can improve these conditions 3.
- Optimal contraceptive selection requires patient and clinician discussion of the patient's tolerance for risk of pregnancy, menstrual bleeding changes, other risks, and personal values and preferences 3.
Benefits of Nexplanon
- Nexplanon is a highly effective method of long-acting reversible contraception 2.
- It has a long duration of action, ranging from 3 years, and does not require maintenance once in place 4.
- Nexplanon can be inserted and removed as an office-based procedure 2.
- Persons will experience a rapid return to fertility once the implant is removed 2.
Risks and Considerations
- Estrogen-containing methods, such as combined oral contraceptive pills, increase the risk of venous thrombosis, whereas progestin-only methods, such as Nexplanon, are associated with rare serious risks 3.
- Clinicians should discuss effectiveness as well as other clinical considerations with patients to allow them to make contraceptive decisions that support their reproductive goals and clinical needs 5.
- Extended use of Nexplanon beyond the Food and Drug Administration approved duration of use for contraception may be a safe, effective, and desirable option for many patients 5.