How to manage fatigue and nausea caused by Nexplanon (etonogestrel) when periods start?

Managing Fatigue and Nausea with Nexplanon During Menstruation

Fatigue and nausea associated with Nexplanon during menstruation typically improve over time as your body adjusts to the hormonal contraceptive, usually within 3-6 months of insertion. While these side effects can be uncomfortable, they can be effectively managed with specific interventions.

Understanding Nexplanon-Related Symptoms

Nexplanon is a highly effective contraceptive implant containing etonogestrel, with typical and perfect use failure rates of less than 1% 1. While it provides excellent contraception for up to 3 years, some users experience side effects that coincide with menstrual bleeding:

• Fatigue and nausea are common side effects that may worsen during menstrual periods
• These symptoms often diminish over time as the body adjusts to the hormonal changes
• Unpredictable bleeding patterns are the most common reason for discontinuation 1

Management Strategies for Fatigue

Energy Conservation Techniques

• Plan important activities during peak energy times of the day
• Prioritize essential activities and use labor-saving techniques
• Maintain daily energy diaries to identify patterns 2

Physical Activity

• Begin with low-intensity exercise and gradually increase as tolerated
• Regular physical activity can paradoxically improve energy levels despite initial fatigue 2

Sleep Optimization

• Limit daytime naps to less than one hour
• Maintain a consistent sleep schedule
• Consider cognitive behavioral therapy techniques for persistent sleep disturbances 2

Nutrition and Hydration

• Ensure adequate hydration throughout the day
• Maintain balanced nutrition with regular meals
• Consider nutritional consultation if fatigue persists 2

Management Strategies for Nausea

Dietary Modifications

• Eat smaller, more frequent meals throughout the day
• Avoid greasy, spicy, or heavy foods that may trigger nausea
• Try dry, bland foods like crackers, especially in the morning

Anti-nausea Interventions

• Ginger (tea, candies, or supplements) may help reduce nausea
• Consider over-the-counter antiemetics if needed for short-term relief
• If nausea is severe enough to require daily antiemetic intervention or causes >5% weight loss, consult your healthcare provider about possible dose adjustments 1

When to Seek Medical Attention

Contact your healthcare provider if:

• Symptoms persist beyond 3-6 months after insertion
• Nausea is severe enough to cause significant weight loss or impact daily activities
• Fatigue is debilitating or accompanied by other concerning symptoms
• You're considering discontinuation due to side effects

Long-term Outlook

Most users find that side effects diminish over time as the body adjusts to the hormonal changes. Recent research suggests that Nexplanon may actually have a protective effect against gastroesophageal reflux disease compared to combined oral contraceptives 3, which could be beneficial for those experiencing nausea.

Important Considerations

• Nexplanon remains one of the most effective contraceptive methods available 1
• The implant can be removed at any time if side effects become intolerable
• Alternative contraceptive methods can be discussed with your healthcare provider if needed
• Maintain regular follow-up appointments to monitor your response to the contraceptive

Remember that while these side effects can be uncomfortable, they are generally not dangerous and often improve with time and appropriate management strategies.