Nexplanon Side Effects – The Full List

David Fuller

Last Updated On: September 23, 2025

Starting a new form of birth control often comes with questions—not just about how well it works, but also about how it might affect the body day to day. Hormonal contraceptives, while highly effective, can bring side effects that range from minor annoyances to changes worth discussing with a healthcare provider.

Nexplanon, a small implant placed under the skin of the upper arm, is one of the most effective long-acting reversible contraceptives available. It protects against pregnancy for up to three years, but like any medication, it may cause side effects. These can differ widely from person to person, with some women experiencing little to no issues and others noticing changes in their menstrual cycle, mood, or overall health.

In this article, we’ll walk through the full list of Nexplanon side effects so you know what to expect, what’s considered normal, and when it may be time to reach out to your healthcare provider.

Key Takeaways

• Nexplanon side effects are most common in the first 3–6 months and often improve as the body adjusts.
• The most frequent changes include irregular bleeding, headaches, mood shifts, skin changes, breast tenderness, and occasional weight concerns.
• Serious risks are rare, but blood clots, device migration, or severe mood changes require prompt medical attention.
• Ovarian cysts may occur ,but usually resolve on their own without treatment.
• Once removed, hormone levels normalize quickly, and most side effects resolve within days to weeks.

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Common Side Effects Experienced with Nexplanon

Most Nexplanon side effects are mild and temporary, often appearing during the first few months after insertion while hormone levels adjust. Patients may notice changes in their cycles, mood, or skin. Setting clear expectations at the start helps reduce worry and improves satisfaction with the implant.

The most frequently reported effects include:

• Irregular Bleeding Patterns: Spotting between periods, longer bleeding episodes, or no periods at all (amenorrhea) are the most common changes. Although inconvenient, these bleeding differences are not harmful and often improve with time.
  
• Headaches: Some women report mild to moderate headaches during the early adjustment phase. These can often be managed with simple over-the-counter pain relief.
  
• Weight Changes: Some users report weight gain, though studies have not consistently shown a direct causal link. Lifestyle factors like eating habits and physical activity may also play a role.
  
• Acne or Skin Changes: Hormonal shifts may cause acne flare-ups, oilier skin, or, in some cases, clearer skin. Responses vary widely.
  
• Breast Tenderness: Soreness or swelling in the breasts may occur shortly after insertion but often improves over time.
  
• Mood Changes: Some users notice irritability, mood swings, or feelings of low mood. While many of these resolve, persistent symptoms should be discussed with a provider.

For most women, these side effects are manageable and temporary. The long-lasting benefits of reliable contraception often outweigh these early adjustments, making Nexplanon a dependable option for many.

Serious or Rare Risks Linked to Nexplanon Use

Though uncommon, some risks associated with Nexplanon require awareness and may need medical evaluation if they occur. Recognizing these possibilities allows patients and providers to act promptly.

• Blood Clots (Thrombosis): Rare cases have been reported. The risk is higher in women who smoke, are obese, or have a personal or family history of blood clots. If a thrombosis occurs, the implant should be removed.
  
• Insertion Site Problems: Pain, swelling, or infection can develop at the placement site. Deep insertion may complicate removal, underscoring the importance of proper placement by a trained provider.
  
• Device Migration: In rare cases, the implant may shift from its original position, making it harder to detect during exams. Imaging may be needed to confirm its location.
  
• Allergic Reactions: Hypersensitivity to the implant’s materials can cause rash, irritation, or swelling. Severe reactions may require removal.
  
• Ovarian Cysts: Benign cysts may occur but are usually symptom-free and often resolve without treatment.
  
• Mood Disorders: Some users report depression or anxiety. While causation is not fully established, significant mood changes should be evaluated by a healthcare provider.

Although rare, these risks underscore the importance of thorough screening before insertion and prompt follow-up if concerning symptoms develop.

How Long Do Nexplanon Side Effects Typically Last

The adjustment phase, which usually spans the first three to six months, is when most side effects are noticed. Irregular bleeding, spotting, headaches, and, less commonly, nausea can occur as the body adapts to hormone changes. Understanding how the Nexplanon dosage works helps explain why these effects often improve as the body stabilizes.

By the six-month point, many women report lighter or less frequent periods, with some experiencing no periods at all. Headaches and nausea often decrease as hormone levels even out. Skin changes or breast tenderness may still appear, but are generally manageable.

For the majority of users, Nexplanon is well tolerated after the initial adjustment. Side effects that arise later, such as mood changes or acne, tend to be mild. Once the implant is removed, hormone levels return to normal quickly, and fertility usually returns within weeks.

Guidance for Clinicians on Managing Nexplanon Side Effects

Healthcare providers play a vital role in helping patients navigate side effects and maintain confidence in their contraceptive choice. Key strategies include:

• Pre-insertion Counseling: Explain possible bleeding changes, mood effects, and other common adjustments so patients know what to expect.
  
• Symptom Management: Recommend over-the-counter pain relief for headaches or breast tenderness, or short-term treatments for bothersome bleeding.
  
• Patient-led Monitoring: Encourage patients to track symptoms and return if they are persistent or severe. Routine follow-ups are not always required unless issues arise.
  
• Alternative Options: If side effects remain disruptive, discuss switching to another contraceptive method.
  
• Education and Reassurance: Clarify that irregular bleeding is not dangerous, even if inconvenient, and that most side effects improve with time.

By addressing concerns early and offering supportive guidance, providers can reduce anxiety, improve adherence, and enhance overall satisfaction with Nexplanon.

Conclusion

Nexplanon offers reliable, long-term contraception with a strong safety profile. While many women experience temporary side effects during the adjustment phase, these are usually manageable and often improve with time. More serious risks are rare, especially when insertion is performed correctly and patients receive clear counseling. 

With proactive education and ongoing support, healthcare providers can help patients balance potential side effects with the significant benefits of this convenient contraceptive option.

FAQs

1. Does everyone experience side effects with Nexplanon?

No. Some women notice only minor changes or none at all, while others may have temporary shifts in mood, bleeding, or skin.

2. Can irregular bleeding with Nexplanon be treated?

Yes. Providers may suggest short courses of hormonal therapy or nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce bothersome bleeding.

3. What are the warning signs that require medical attention?

Seek care if you have severe headaches, chest pain, leg swelling, or persistent pain or infection at the implant site.

4. Do Nexplanon side effects stop after removal?

In most cases, yes. Hormone levels return to baseline quickly after removal, and side effects usually resolve within days to weeks.

References

Birth control. U.S. Food And Drug Administration. Updated May 10, 2024. https://www.fda.gov/consumers/womens-health-topics/birth-control

Teal S, Edelman A. Contraception selection, effectiveness, and adverse effects. JAMA. 2021;326(24):2507. doi:10.1001/jama.2021.21392

Palomba S, Falbo A, Di Cello A, Materazzo C, Zullo F. Nexplanon: the new implant for long-term contraception. A comprehensive descriptive review. Gynecological Endocrinology. 2012;28(9):710-721. doi:10.3109/09513590.2011.652247

Barakat S, Hashem HA, Fyala E, Ghanem A. Menstrual bleeding profile, adverse effects and effectiveness of an etonogestrel subdermal implant: A prospective study. Evidence Based Women S Health Journal. 2024;0(0):0. doi:10.21608/ebwhj.2024.277466.1316