From the Guidelines
For patients experiencing continuous bleeding on Nexplanon, the recommended treatment options include NSAIDs, 5–7 days, hormonal treatment, 10–20 days, or antifibrinolytic agents, 5 days, as these have been shown to be effective in managing bleeding irregularities. When managing bleeding irregularities while using contraception, such as Nexplanon, it is essential to explore patient goals, including continued method use or method discontinuation 1. If the patient wants to continue use, provide reassurance and advise the patient that they may contact their provider at any time to discuss bleeding irregularities or other side effects. The following treatment options may be considered for implant users, depending on the patient’s preferences, treatment goals, and medical history:
- For spotting or light bleeding or heavy/prolonged bleeding; treatment may be repeated as needed:
- NSAIDs, 5–7 days
- For heavy or prolonged bleeding:
- Hormonal treatment (e.g., low dose COCs or estrogen), 10–20 days
- Antifibrinolytic agents (e.g., tranexamic acid), 5 days It is also crucial to consider an underlying health condition, such as interactions with other medications, sexually transmitted infections, pregnancy, thyroid disorders, or new pathologic uterine conditions (e.g., polyps or fibroids), and treat the condition or refer for care if necessary 1. If the patient desires removal or discontinuation of the method at any time, remove the method, offer counseling on alternative contraceptive methods, and initiate another method if desired. These recommendations are based on the most recent guidelines for contraceptive use, which prioritize patient-centered care and effective management of bleeding irregularities 1.
From the Research
Continuous Bleeding on Nexplanon Treatment Options
- Continuous bleeding is a common side effect of Nexplanon, a type of etonogestrel-releasing implant 2
- The management of unscheduled bleeding during contraception with Nexplanon is an important aspect of its use, and healthcare providers should be aware of the practical advice and technical tips for managing this side effect 3
- Studies have shown that abnormal menstruation is the most commonly reported side effect of Nexplanon, and it can affect the continuation rates of the method 2
- The one-year continuation rates of Nexplanon range from 57-97%, and the method is considered clinically effective and safe, yet the continuation rates are lower compared to other long-acting reversible contraceptives (LARC) such as the levonorgestrel intrauterine system (LNG-IUS) and copper intrauterine device (Cu-IUD) 2
- Factors associated with the choice of Nexplanon or other LARC methods include previous contraceptive use, feelings towards pregnancy, stress, and weight, and healthcare providers should take these factors into account when counseling patients about their contraceptive options 4
Treatment Options for Continuous Bleeding on Nexplanon
- There is limited information available on specific treatment options for continuous bleeding on Nexplanon, and further research is needed to determine the most effective management strategies for this side effect
- However, studies suggest that healthcare providers should be aware of the potential for bleeding disturbances with Nexplanon and should be prepared to manage these side effects in order to improve patient satisfaction and continuation rates 3, 2