Pre-insertion counselling and the Nexplanon implant

Before inserting the Nexplanon implant it is important to inform women of the potential benefits as well as the possible adverse effects of progestogen-only contraception so that they can make an informed decision.² The most common reasons for the removal of the Nexplanon implant are menstrual bleeding pattern changes and side effects that are common to hormonal contraception in general (e.g. headache, breast tenderness, weight changes).¹ In many women, bleeding irregularities and side effects decrease with time and women may find that the convenience and efficacy of Nexplanon far outweigh any initial inconveniences.^{13, 32}

The acceptability of a particular treatment and its possible side effects are influenced by a woman’s personal, social and cultural background and this may affect how she perceives changes in menstrual bleeding patterns. For example, some women may view amenorrhoea as a desirable effect of progestogen-only contraception, although for others it may be perceived as a negative point if they would like the reassurance of a regular cycle.

Explaining that Nexplanon is a highly effective contraceptive implant and that amenorrhoea and other bleeding changes may occur and that these may settle with time can help women to decide if the Nexplanon implant is the right choice for them. It will also ensure that women do not request removal before their menstrual cycles have had the chance to settle and give them the opportunity to have a proven effective means of long-acting reversible contraception.

Women should also be informed of the insertion and removal procedure for the Nexplanon implant, including the small risk of compilations that may occur.

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