From the Guidelines
Nexplanon does not directly affect the onset or progression of menopause. Menopause is a natural biological process that occurs when the ovaries stop producing eggs and hormone levels decline. Nexplanon, a hormonal contraceptive implant, releases a synthetic progestin called etonogestrel, which is different from the hormones that decline during menopause (primarily estrogen and progesterone) 1.
Key Considerations
- The primary concern with Nexplanon and menopause is not the onset or progression of menopause itself, but rather how Nexplanon may mask symptoms of perimenopause, such as irregular bleeding.
- According to the U.S. Selected Practice Recommendations for Contraceptive Use, 2013, a significant proportion of etonogestrel implant users experience amenorrhea or infrequent spotting, which could potentially mask perimenopausal symptoms 1.
- It is essential to discuss these potential effects with a healthcare provider, especially for women approaching the typical age for menopause, to monitor for signs of menopause and consider alternative contraception methods as needed.
Clinical Implications
- The effects of Nexplanon are reversible upon removal, and natural hormone patterns will resume 1.
- Women using Nexplanon should be aware of the potential for masked perimenopausal symptoms and discuss any concerns with their healthcare provider.
- Healthcare providers should consider the potential impact of Nexplanon on perimenopausal symptoms when counseling patients about contraceptive options and menopause management.
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 nonhormonal therapy options for perimenopausal and menopausal symptoms.
- Nexplanon is not mentioned in any of the studies, suggesting that there is limited research on its specific impact on menopause.
Menopausal Symptoms and Treatment
- Menopausal symptoms, such as hot flashes, night sweats, and genitourinary symptoms, can be treated with hormonal and nonhormonal options 2, 3, 4, 5.
- Hormone therapy with estrogen is considered the first-line treatment for bothersome vasomotor symptoms and genitourinary symptoms, but nonhormonal medications and lifestyle changes can also be effective 2, 3, 4, 5.
Hormonal Changes During Menopause
- The menopause transition is characterized by a decline in ovarian follicular activity, leading to changes in hormone levels, including a decrease in estradiol and an increase in follicle-stimulating hormone (FSH) 6.
- These hormonal changes can contribute to the development of menopausal symptoms, such as hot flashes and night sweats 6.