Implant ( Nexplanon)

Question 1

Efficacy?

Answer 1

> 99%

Question 2

Acne?
Weight Gain?
VTE Risk?

Answer 2

Can increase
Some ( less than injection)
Neutral

Question 3

Bleeding
Cycle Control
Withdrawal/SPotting?

Answer 3

No - unpredictable bleeding
average is 5 days per month at 1 year of use
22% amenorrhea at 2 years

Question 4

Adverse Effects

Answer 4

Implant site reaction, migration ( rare)

Question 5

Return to Fertility?

Answer 5

fast, ovulate within 1 month

Question 6

Additional Considerations

Answer 6

Good long acting option with avoiding an IUD
Cases of infection, pulmonary migration, allergic reactions and insertion-related neuropathies

Question 7

Initiation and Dosing

Answer 7

Removable rod planted every 3 years ( maybe up to 4 years effective)
Use back up contraception for 7 days if not started within 5 days of onset of menses
70 mcg/day of etonogestrel down to 25 mcg per day at 3 years

Question 8

How to manage irregular bleeding?

Answer 8

NSAIDS for 5-7 days
COC 10-20 days
Norethindrone twice daily for 20 days