In January of 2022, on the online discussion forum Reddit, user DiscoAlienQueen posted a question with the subject line, “Nexplanon – Dizziness?” In the body of her post, she wrote,
"I got [Nexplanon] inserted September 8th. Everything has been fine but for the past few weeks I’ve been so dizzy and light headed in the morning it’s hard to function. It’s like I wake up with a terrible hangover but I don’t even drink. Has this happened to anyone else? It is starting to worry me and nothing has changed for me recently besides getting Nexplanon."
Other Reddit users responded sympathetically. User PineappleFinancial31 replied, “I got my [Nexplanon implanted] in early November and I am feeling out of it.” User Jadevreeland replied, “I got mine in August and I’m still feeling tired… it’s hard to get out of bed, I’ve never been like this before.” User WarmHoneyBuns replied, “I’ve been feeling really fatigued. It’s probably our bodies adjusting to the hormones.” User Megan_Kelly24 replied, “I would experience dizziness a lot while I was on Nexplanon for 4 years. I didn’t put two and two together until a few months back. I got it removed and haven’t felt dizzy since.” User DiscoAlienQueen replied, “So glad I’m not alone. I just feel I don’t have a justifiable reason to get it out because my doctor doesn’t seem to think I [need to] with my side effects.”
It was an online forum like this one where Sloan, at age nineteen, learned that headaches, dizziness, and fainting spells could be potential side effects of Nexplanon. In 2017, an online chat forum was the only place she could find information about these adverse side effects; she’d asked her mother and her doctor about it – both of whom said it was unlikely, if not impossible, for Nexplanon to cause such a reaction – and she’d researched contraceptives on credible medical websites and couldn’t find the information she needed. Though she suspected her Nexplanon implant made her feel dizzy, it was difficult to find proof.
Sloan had Nexplanon implanted in her arm when she was seventeen years old. She had been dating her boyfriend – and now husband – for three years, and when they became sexually active, she decided she wanted to use hormonal birth control in addition to condoms for extra protection from unwanted pregnancy. She researched all of the birth control options and settled on Nexplanon because she thought it would be convenient compared to other forms – such as the pill, which she didn’t think she could remember to take every day.
Shortly after having Nexplanon implanted, Sloan began experiencing random fainting spells. The first time it happened, she was shopping at JCPenney with her boyfriend. Suddenly, Sloan felt an intense headache come on, as if she had “hit [her head] on concrete.” She told her boyfriend she needed to leave immediately. He dropped all of their items and half-carried her back to the car, where she blacked out for about twenty seconds before coming to. For the rest of that day and the day after, her head continued to ache as if something were squeezing the sides of her brain.
Sloan did not immediately suspect her birth control of causing this episode. Her doctor had only warned her of possible weight gain and unpredictable bleeding, and nothing along the lines of headaches, dizziness, or fainting had come up in her research. Interestingly, online resources such as Planned Parenthood, as of December 2022, did not list dizziness as a side effect of Nexplanon on their website, and described unpredictable bleeding as the main side effect of Nexplanon, and headaches, breast pain, nausea, weight gain, and ovarian cysts as “less common side effects” (What). It’s remarkable that an entity such as Planned Parenthood would provide an incomplete list of side effects. According to a 2017 study, the same year Sloan was searching for answers to her questions about birth control, Planned Parenthood was the leading source of publicly funded contraceptive care, serving 32% of all contraceptive patients in the United States (irreplaceable). So if Planned Parenthood does not provide this information, nearly one in three birth control users are left in the dark.
Unfortunately, along with Planned Parenthood, many reputable resources provide incomplete lists of side effects. For example, in a Birth Control Guide for educational purposes, the Food and Drug Administration lists “some side effects” of Nexplanon, including menstrual changes, mood swings, depression, weight gain, acne, and headache, but does not mention dizziness (Birth). What’s more, the list of side effects varies depending on the source. For example, The Mayo Clinic does include dizziness as a side effect of Nexplanon, as well as abdominal or back pain, decreased sex drive, vaginal dryness, and insulin resistance, all side effects which are not listed on other websites (Contraceptive). Furthermore, the Nexplanon website lists “dizziness” along with all previously mentioned side effects, but also adds viral infections, nervousness, and, put simply, “pain” (Risks). For some reason, no one can seem to agree on a complete list of Nexplanon side effects. And when popular and respectable resources fail to provide reliable information, girls like Sloan suffer.
Sloan experienced a “blackout” once every two or three months, and for a long time, she had no idea why. On several occasions, Sloan would miss class or leave abruptly in the middle of class because she felt like she was going to faint. She attributed these side effects to the stress of a change in lifestyle – she graduated from high school, moved away from home, and started her freshman year of college. When she complained of side effects to her doctor, her doctor told her that her body would adjust to the new hormones eventually. This is common advice; for example, Planned Parenthood begins their discussion of Nexplanon side effects on their website with the disclaimer, “The implant may cause side effects for some people, but they usually go away after a few months” (What). Sloan waited for her side effects to ease for nearly two years.
“At the beginning I played it off, I was like this happens to everyone, I feel bad but it will feel better,” Sloan said. “I was frustrated because no one was listening.”
Sloan began to worry that there was something wrong with her brain – perhaps a brain tumor. She begged for a neurological exam, but when she finally had one done, it seemed there was nothing physically wrong with her. Eventually, Sloan Googled her symptoms – typing “Nexplanon side effects” into the search bar.
“[I found] some forum where everyone shared what was going on with them,” Sloan said. “[Nexplanon] was essentially causing all these women to have headaches, dizziness, blurry vision, nausea. It was nice to see that other people were going through the same thing. At first I almost couldn’t believe it, because this [information] isn’t anywhere else, if you ask your doctor about it they don’t tell you any of those things, there aren’t any pamphlets about it.”
When Sloan told her mother what she had learned, her mom said, “Oh I doubt it’s that, that seems pretty rare.” Feeling empowered despite this, Sloan went ahead and had her Nexplanon removed anyway. She made the right decision, as it's possible her symptoms were precursors to a much more serious condition. To explain, neurologist Benjamin Jewett discusses in his article “Pseudotumor Cerebri Following Nexplanon® Implantation” the relationship between hormonal birth control and Pseudotumor Cerebri (PTC), meaning, “false brain tumor,” which is a condition characterized by an increase of fluid pressure in the brain which can lead to blindness. He describes the case of a 27 year old woman who began experiencing headaches, vision loss, vomiting, and balance issues about two months after having Nexplanon implanted. She reported no other changes in her medical history, so doctors removed the Nexplanon implant immediately. Her CTs and MRIs appeared normal. Doctors performed a lumbar puncture to drain cerebrospinal fluid from her brain. When this treatment alleviated her symptoms, she was diagnosed with PTC. Jewett writes that the relationship between PTC and Nexplanon remains controversial, but because as many as 25% of Nexplanon users experience headaches, Jewett urges medical professionals to be alert to this potential side effect (Jewett). Sloan does not know exactly the reason for her blackouts, but she does know they were related to Nexplanon. Since having Nexplanon removed, Sloan has not had a single fainting spell, though she still suffers intense migraines. She now takes the birth control pill, which she finds inconvenient, but she prefers the pill to the IUD.
“I don’t want anything implanted in me ever again,” Sloan said. “I am curious to see if I stop taking [birth control all together] if my migraines will go away. I’ve thought about [quitting birth control], but I’m afraid if I go off of [birth control] I’m never gonna want to go back on it – like, if all the fogginess went away and I would never want to go back, and I don’t want to have a baby.”
Sloan wishes she didn’t have to deal with birth control, but she feels she’s considered all of her options and the pill is at least tolerable. Now, she is 24 years old, and she tells anyone and everyone she can about the experience she had with Nexplanon.
“I bring it up in conversation and people are like, ‘oh my gosh that happened to me,’” Sloan said. “The more you talk about it the more relatable it is. Just talking to people that are close to my age and going through the same thing definitely helps.”
Works Cited
“Birth Control Guide.” FDA, United States Food and Drug Administration , 2011.
“Contraceptive Implant.” Mayo Clinic, Mayo Foundation for Medical Education and Research,
15 June 2021.
“The Irreplaceable Role of Planned Parenthood Health Centers.” Planned Parenthood, Planned
Parenthood Federation of America, Jan. 2020.
Jewett, Benjamin E, et al. “Pseudotumor Cerebri Following Nexplanon® Implantation.” U.S.
National Library of Medicine, PubMed Central, 18 May 2018.
“Risks and Side Effects of NEXPLANON.” NEXPLANON® (Etonogestrel Implant) 68 Mg
Radiopaque, Organon, 2022.
“What Are the Side Effects of the Birth Control Implant?” Planned Parenthood, Planned
Parenthood, 2022.
Interview conducted October 25, 2022 by phone.