What causes hot flashes after removal of Nexplanon (etonogestrel)

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Last updated: April 1, 2025View editorial policy

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From the Research

Hot flashes after Nexplanon removal are a common side effect that typically occurs as your body adjusts to natural hormone production again, and the most effective management strategy is to try non-hormonal medications such as certain antidepressants, as recommended by the most recent study 1. To manage symptoms in the meantime, try:

  • Wearing lightweight, breathable clothing in layers
  • Keeping your bedroom cool at night
  • Avoiding triggers like spicy foods, alcohol, and caffeine
  • Practicing stress reduction techniques such as deep breathing or meditation Staying hydrated and maintaining regular exercise can also help regulate body temperature. If hot flashes are severe or persist beyond 3-6 months, consult your healthcare provider, as they may recommend short-term treatments like low-dose hormonal options. Hot flashes occur because Nexplanon contains synthetic progestin that suppresses your natural hormone cycles, and when removed, your body needs time to resume normal hormone production, which can cause temperature regulation issues during the transition period. The use of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) has been shown to be effective in managing menopausal hot flashes, with escitalopram, paroxetine, and fluoxetine being the most effective SSRIs, and venlafaxine and desvenlafaxine being the most effective SNRIs 1. It is essential to note that the benefits and risks of hormone replacement therapy (HRT) should be carefully considered, and the current recommendations for HRT use in menopausal women should be followed 2. Selective estrogen receptor modulators (SERMs) may also be an alternative to HRT, but their use should be individualized and based on the specific needs and risks of each patient 3, 4, 5.

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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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