Implanon and bleeding between periods

Dear Helen,

Anything unexpected — rain on a sunny day, a mid-sleep phone call, and certainly a period that just won’t quit — has the potential to be very annoying. Despite the frustration, perhaps you’ll be reassured to hear that you’re not alone: irregular menstrual bleeding is a very common side effect for those using the contraceptive Implanon, and the updated version called Nexplanon. This irregular bleeding can take on a variety of forms: irregular spotting, prolonged bleeding, or amenorrhea (which means periods stop altogether). In fact, 17.7 percent of women had prolonged spotting or bleeding for at least 14 consecutive days in the clinical trials of the contraceptive, and this side effect is so common that it’s included on the patient consent form. About one in ten actually decided to quit using Implanon because of the effects on their menstruation. So, long story short, what you’re experiencing is not out of the ordinary. Unfortunately, there isn’t really any way to know whether it will stop anytime soon. Each person’s experience is a bit different, and although regular bleeding does get back on track for some after a few months of use, the makers of Implanon and Nexplanon say that the irregularities may continue the entire time the implant is being used.  

Despite this potentially disruptive side effect, there are numerous reasons why people choose implantable contraceptives like Implanon and Nexplanon. One of the major advantages is convenience; hormones are automatically released over three years, eliminating the need to remember to take a pill each day. The updated version, Nexplanon, has some additional benefits. It’s now easier for health care providers to remove because it can be seen on x-rays, and the implantation mechanism itself has been improved. One caveat is that there are questions about its effectiveness in users who are overweight, as there is a relationship between body weight and the concentrations of the hormone from the implant in the bloodstream (though more research is needed). For the most part, though, it’s often seen as an easy, breezy contraceptive, especially for those who aren’t experiencing any side effects.

Since you are experiencing some unpleasantness, you have a few options: First, it’s recommended by the manufacturers that you consult with a health care provider if you are experiencing any irregular, prolonged, or missed periods just to rule out any other possible causes. You could also just decide to give the implant a little more time. The irregularities do stop for some users, so it could be worth holding out hope for a little longer, especially if you feel like an implant is the right contraceptive choice for you. Finally, you could consider exploring alternative contraceptive methods that do not require daily maintenance. To that end, you might find options like an intrauterine device (IUD) or NuvaRing to be just as convenient as Implanon. Keep in mind that any contraceptive can have side effects, so it may just take some trial and error and a few heart-to-hearts with your health care provider to find the best option for you.

You mention that the bleeding is interfering with your relationship. Might this be because you are avoiding sexual contact while you're bleeding? Although you can't necessarily control spotting between periods, you can still enjoy normal sexual activity even while on your so-called flow. Contrary to some myths, it's perfectly normal to have sex while having your period or experiencing spotting. If this is not the issue, how is this situation interfering with your relationship? What might help overcome the interference? Consider talking with your partner about your feelings and concerns. Or, if you're simply concerned about making a mess, laying down a dark towel might be just the thing. If you’re not sure you’re up for having sex during your period, you can also use this time as an opportunity to get creative with other sexually arousing activities that won’t actually involve intercourse. Whether you decide to persevere with the contraceptive implant or try something new, here’s hoping that Aunt Flow gets back on track soon!