From the Guidelines
Nexplanon does not directly affect menopause, but it can mask some menopausal symptoms. Nexplanon is a hormonal contraceptive implant that releases etonogestrel, a synthetic progestin, which can suppress menstruation and regulate hormones, potentially hiding typical menopausal symptoms like irregular periods 1. The implant's primary function is to prevent pregnancy, and it does not change the timing of menopause or alter the underlying biological processes.
Key Considerations
- Nexplanon can make it challenging to identify when natural menopause begins because it may regulate hormones and suppress menstruation 1.
- Women using Nexplanon who are approaching menopausal age (typically around 51) should consult their healthcare provider about monitoring for menopause.
- The implant remains effective for pregnancy prevention during perimenopause, the transition phase before menopause.
- Individual health factors should be considered, and regular check-ups are recommended to assess the need for continued use or alternative methods as women age.
Bleeding Patterns and Menopause
It's essential to discuss common side effects, such as unscheduled spotting or light bleeding and amenorrhea, especially during the first year of use, as these can be mistaken for menopausal symptoms 1. A pooled analysis of data from 11 clinical trials indicates that a significant proportion of etonogestrel implant users had relatively little bleeding, with 22% of women experiencing amenorrhea and 34% experiencing infrequent spotting 1.
Clinical Implications
Healthcare providers should be aware of the potential for Nexplanon to mask menopausal symptoms and consider this when evaluating women approaching menopausal age. Regular monitoring and open communication can help ensure that women using Nexplanon receive appropriate care and guidance as they transition through menopause.
From the Research
Nexplanon and Menopause
- There is no direct evidence in the provided studies that Nexplanon (etonogrel) affects menopause 2, 3, 4, 5, 6.
- The studies focus on the management of menopausal symptoms, hormonal changes during the menopause transition, and treatment options for menopause symptoms, but do not mention Nexplanon specifically.
- Nexplanon is a type of contraceptive implant that releases etonogestrel, a type of progestin, but its effects on menopause are not discussed in the provided studies.
Menopause Symptoms and Treatment
- Menopause symptoms, such as hot flashes, night sweats, and genitourinary symptoms, can be treated with hormonal and non-hormonal options 2, 3, 4, 6.
- Hormonal therapy with estrogen is a common treatment for menopausal symptoms, but non-hormonal medications, such as paroxetine and venlafaxine, can also be effective 2, 3.
- The menopause transition can last for over a decade and causes symptoms in a majority of women, making it important for clinicians to recognize early signs and symptoms and offer treatment to mitigate these symptoms 4.
Hormonal Changes During Menopause
- The menopause transition is characterized by a decline in ovarian follicular activity, leading to a decrease in estrogen levels and an increase in follicle-stimulating hormone (FSH) levels 5.
- Estradiol levels remain relatively unchanged or tend to rise with age until the onset of the transition, and then decrease significantly during the late perimenopause 5.
- Testosterone levels tend to fall by about 50% during reproductive life, but change little during the transition, and may even rise after menopause 5.