Experiencing Heavy Periods After Nexplanon Insertion
I'm a 20-year-old female, currently taking 25 mg of Lexapro and 4 mg of drospirenone. I also smoke. Five months ago, I underwent the insertion of Nexplanon, a contraceptive implant placed in the arm. At first, I experienced minimal bleeding, which appeared dark brown and wasn't alarming. However, after a few weeks, the flow intensified to what felt like a heavy menstrual period, and the blood changed to bright red. I’ve visited my healthcare provider multiple times regarding this issue, and they prescribed hormones in an attempt to help regulate the bleeding. Despite a month of using drospirenone, I have not observed any improvements; in fact, my bleeding has become even more pronounced. Now I find myself uncertain about next steps. Should I simply be patient and let this run its course, or should I be concerned? It's important to mention that prior to using Nexplanon, I had been on Alesse birth control pills since I was 13 to help with heavy menstrual flow and painful cramps.
Answers (1)
9/8/2025, 4:10:37 PM
OpenHealth AI
Experiencing heavy bleeding after the insertion of Nexplanon can be concerning, especially since you’ve previously managed heavy menstrual flow with birth control pills. The changes you've noticed suggest that your body is reacting to the new contraceptive method, which can sometimes happen. While some bleeding irregularities are common in the first few months after Nexplanon insertion, intensified bleeding needs attention.
Explanation:
Nexplanon can cause a range of menstrual changes, including irregular, heavy, or prolonged bleeding, especially in the initial months. Hormones like drospirenone are often prescribed to help regulate these changes, but it appears they haven't provided relief in your case. Since you were already prone to heavy periods before, it’s understandable to feel concerned, particularly with a change in bleeding pattern. It's also important to factor in your smoking, as it can sometimes influence hormonal therapies and overall health.
Next Steps:
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Track Your Symptoms: Maintain a detailed record of your bleeding—note the duration, quantity (light, moderate, heavy), and any associated symptoms like pain. This information is valuable for your healthcare provider.
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Monitor for More Severe Symptoms: Pay attention to any new symptoms such as dizziness, increased heart rate, or symptoms of anemia (like excessive fatigue or weakness). If these occur, increase the urgency of seeking medical advice.
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Consider a Follow-Up: While you’ve seen your provider previously, consider asking for a more focused discussion about ongoing treatments. You might explore alternatives to drospirenone or even discuss other options, such as an ultrasound to rule out any anatomical issues or other conditions that might be contributing to your heavy bleeding.
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Lifestyle Adjustments: If possible, consider reducing or quitting smoking. This can improve your overall health and the efficacy of medications—discuss smoking cessation aids with your provider if this is something you’d like to pursue.
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Prepare for a Second Opinion: If the heavy bleeding continues without relief, consider seeking a second opinion from a specialist, such as a gynecologist, who has experience dealing with hormonal contraception and menstrual irregularities.
Your concerns are valid, and it's important to advocate for your health. Keeping open communication with your healthcare provider and being observant of your symptoms will help guide you toward a solution that works for you. Let me know if you have further questions or would like more information on this topic.
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