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Medically reviewed by, Russell Braun RPH
Nexplanon (Etonogestrel) is a newer brand name implantable birth control option. Nexplanon is a progestin only form of birth control.
Nexplanon provides contraception without the risk of forgetting to take medication, which can result in pregnancy. Statistics show that weight gain may be a side effect, but the amount of weight gain is typically not significant.
The soft, flexible Nexplanon rod is inserted via a medical procedure by your doctor into your upper arm. Thus you don’t have an easy option of stopping the drug if you start to see weight gain. With other birth control options, women can ask their doctor to switch to an alternate therapy if weight gain seems to be an issue.
Nexplanon was approved by the Food and Drug Administration for long term contraception, lasting up to three years. After three years Nexplanon can be removed to allow for pregnancy or another dose of Nexplanon can be implanted.
General Contraceptive Stats
- 61 million U.S. women are of reproductive age (15-44).1
- 60% of women of reproductive age use a contraceptive method.1
- 72% of woman using contraception use a nonpermanent method.1
- Nexplanon has been found to be 99% effective in preventing pregnancy with 1 rod inserted for up to 3 years.2
Be sure before you select a birth control
Unsure if you are pregnant? If so, testing before starting a new birth control method is a must.
How Nexplanon Works Key to Effect on Weight?
The implant releases a continuous amount of the progestin hormone etonogestrel. During the first few months the implant is releasing a larger dose of etonogestrel, somewhere in the range of 60-70mcg per day. The amount of drug released per day continues to decrease over the three year period.
By the end of year three only 25-30mcg per day are being released. After that point the dosage of etonogestrel being released might not be sufficient to ensure preventing pregnancy.
Clearly, this tapered dose that is much higher in year one than year three has the potential for more side effects, which could include weight gain.
35-45% 68 mcg dose released year 1
25-30% 68 mcg dose released year 2
20-25% 68 mcg dose released year 3
While no studies have currently looked at Nexplanon weight gain during year 1, 2 and 3 the high influx of the progestin like hormone disturbs your natural hormone balance. The reason for this is that progestin causes water retention, causing a feeling of being bloated without actually changing body fat percentage.
This may be why many women complain of weight gain with Nexplanon, but the studies don’t see weight gain persist over the long term.
Most common adverse reactions to Nexplanon. 2
- Headache 24.9%
- Vaginitis 14.5%
- Weight gain 13.7%
- Acne 13.5%
- Breast pain 12.8%
- Abdominal pain 10.9%
- Pharyngitis 10.5%
Irregular Menstrual Bleeding
Irregular menstrual bleeding was the number one side effect of Nexplanon that caused discontinuation.2 Most women associate menstruation with a feeling of weight gain or fluctuation. This makes sense why they would associate weight changes with the drug itself.
- 11.1% discontinued (had the implant removed) due to changes in menstrual bleeding.2
Weight Gain Studies
2014 Cochrane Study
- Pills and patches used for contraception containing similar hormones, did not look at Nexplanon!
- Measured body composition at day 0 and at one year.
- Concluded not likely to gain weight from contraceptives.
- This study is the basis for most clinicians stating that contraceptives do not cause weight gain.
- Source: 2014 Cochrane Review
- 75 women received Nexplanon and 75 received Intra Uterine Device (IUD) contraception.
- Measured body composition at day 0 and at one year.
- Small increase in weight in Nexplanon group.
- 2% increase in body fat in Nexplanon group.
- Source: Springer Link
The study authors concluded that Nexplanon caused an increase in weight and body fat composition. However, the amounts were small and could be due to other factors such as diet and exercise of the study participants.
- 208 women received Nexplanon and 206 who received nothing were the control group.
- After 3 months, 15.3% in the Nexplanon group perceived weight gain and only 4.3% in the control group perceived weight gain.
- Actual weigh gain between the two groups did not differ significantly, 0.5kg in the Nexplanon group vs 0.0kg in the control group.
The conclusion of the study was women felt that they had gained weight, even though the data did not show that. Researchers think the perception was due to being told of that as a possible side effect prior to receiving the implant.
- Looked at women who had just given birth and tracked their return to pre-pregnancy weight.
- 57 women received Nexplanon and 70 received contraceptives that were non-hormone containing.
- Measured body weight six month after giving birth.
- 42% in Nexplanon group returned to within 1.5kg of pre-pregnancy weight.
- 67% in non hormone containing group returned to pre-pregnancy weight.
- These results were not statistically significant
- Source: Science Direct
Authors concluded a somewhat lower proportion of patients using the implant returned to pre-pregnancy weight after 6 months.
What do the stats mean?
Weight gain is a very individualized effect that some drugs can have on patients. All the studies mentioned above had patients with differing diet, exercise and health habits that are not likely to be just like yours. Also, keep in mind that the average doesn’t meant that some patients lost weight or gained a lot of weigh while on Nexplanon. Rather it is just an average.
A variety of factors can cause weight gain including age, diet, exercise habits, health issues, age and smoking status. You should discuss these with your doctor when you weigh the potential benefits of birth control you don’t have to remember to take vs. the potential risk for weight gain.
Another thing to keep in mind is that most women as they age will gain 1-2 pounds per year naturally due to some factors listed above.
Now that you know that the statistics on Nexplanon are mixed on weight gain, is Nexplanon for you? Before you decide please look at the cost of Nexplanon to help you decide if it is a better option than other forms of contraception.
If you do decide to take Nexplanon or any other form of hormonal birth control please talk to your doctor right away if you notice significant weight gain. That is not normal and needs to be addressed immediately.
Click here to get Dr. Jason Reed’s exclusive list of medication questions you MUST ask your doctor, for FREE!
Share your story!
Have you used Nexplanon? How well did it work for you? Please chime in below with your comments and thoughts below