Can Nexplanon Cause Dizziness?
Yes, dizziness is a recognized adverse effect of Nexplanon (etonogestrel implant), though it occurs infrequently and is typically transient, particularly in the immediate post-insertion period.
Documented Evidence of Dizziness
- Dizziness is listed as an established adverse reaction associated with combination hormonal contraceptives, and this applies to hormonal contraceptive methods including etonogestrel-containing products 1
- The FDA drug labeling for etonogestrel products specifically includes dizziness among reported adverse reactions, though it does not specify exact incidence rates 1
- Some patients may experience dizziness after IUD or implant placement procedures, which usually resolves after resting for a short time 2
Clinical Context and Mechanism
The dizziness associated with Nexplanon can occur through two distinct mechanisms:
Procedure-Related Dizziness
- Vasovagal response during or immediately after insertion is common and typically self-limited 2
- This type of dizziness is related to the insertion procedure itself rather than the hormonal effects of the device 2
- Patients should be counseled that post-procedure discomfort or dizziness usually settles after resting briefly 2
Hormone-Related Dizziness
- Dizziness may occur as a systemic hormonal side effect, similar to other progestin-based contraceptives 1
- This is generally less common than procedure-related symptoms and may persist beyond the immediate post-insertion period 1
Practical Management Recommendations
Pre-insertion counseling should include:
- Advising patients to eat a light meal and drink water before the procedure to maintain blood sugar and hydration 2
- Informing patients they may experience transient dizziness and should plan accordingly (consider having a support person or ride home) 2
- Setting realistic expectations that most dizziness resolves quickly with rest 2
Post-insertion management:
- Allow patients to rest after insertion if dizziness occurs 2
- Reassure patients that procedure-related dizziness is typically self-limited 2
- If dizziness persists beyond the immediate post-insertion period or is severe, evaluate for other causes unrelated to the implant 1
Important Caveats
- Dizziness is not among the most common adverse effects of Nexplanon—the most frequent side effects (occurring in 5-14% of users) include vaginitis, headache, upper respiratory infections, vaginal secretion, sinusitis, weight gain, and nausea 1
- Persistent or severe dizziness warrants evaluation for alternative etiologies, as it is not a typical long-term side effect of etonogestrel 1
- The overall safety profile of Nexplanon remains favorable, with most adverse effects being non-serious 3