Norethisterone and Contraceptive Implant: Do Not Combine
Norethisterone (a progestin) should not be added to a contraceptive implant (e.g., Nexplanon/etonogestrel implant).
Why
- The implant provides continuous progestin release; additional progestin increases side effects without added contraceptive benefit.
- Risks: irregular bleeding, headache, nausea, breast tenderness, mood changes, weight gain.
- No evidence of improved efficacy; implant alone is >99% effective.
If Bleeding Is Problematic
Contact your provider. Options include: short-course estrogen (estradiol), NSAIDs (ibuprofen), doxycycline, or tranexamic acid—per clinical guidelines. Do not self-medicate with extra progestin.
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