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Nexplanon vs Depo-Provera – Which Is Better?

By: Author Health Guide's Editorial

Posted on Last updated:

This article reveals the differences between Nexplanon and Depo-Provera:

Nexplanon

This birth control implant is a tiny, thin rod of the size of a matchstick. It contains 68mg of etonogestrel. This hormone mimics progesterone, a natural hormone which regulates the menstrual cycle along with estrogen.

It is a simple procedure which can be done by your gynecologist or primary care provider.

The implant releases hormones into the body and prevents you from getting pregnant.

According to the producer, it lasts for 3 years, but new research shows that you can use it for 4 years.

Depo-Provera

It is a highly effective method of contraception that is given every three months. It contains medroxyprogesterone acetate, a derivative of progesterone.

The hormone is injected into a muscle, commonly during the first 5 days of a period.

Side Effects

Nexplanon

Possible side effects include:

  • depressed mood;
  • shorter or longer bleeding during the period;
  • acne;
  • no bleeding at all during the time of the period;
  • headache;
  • spotting between the periods;
  • weight gain;
  • mood swings;
  • varied amounts of time between your periods.

Problems related to removal or insertion:

  • the implant can break, making removal difficult;
  • pain, swelling, irritation, or bruising at the insertion site;
  • injury to blood vessels or nerves in your arm during removal or insertion;
  • scarring around the insertion site;
  • if it is inserted too deeply or has moved, there may be a need for surgery in the hospital to remove the implant;
  • infection;
  • the implant may come out by itself if it becomes infected or if it was not inserted completely;
  • scar tissue may form around the implant, making it difficult to remove.

Depo-Provera

Possible side effects include:

  • mood changes;
  • your periods may change in a way that is not acceptable to you;
  • bloating;
  • breast tenderness;
  • acne;
  • there could be a delay of up to 12 months in the return of fertility after stopping the use of this method of contraception;
  • fluid retention;
  • allergic reactions;
  • a reduced interest in sex, especially for women who are prone to depression;
  • abdominal discomfort;
  • headaches;
  • weight gain sometimes occurs.

Notes

  • getting this method of contraception while pregnant can lead to low birth weight;
  • the manufacturer encourages long-term use (over 2 years) “only if other methods of birth control are not right for you;”
  • it will not protect you from sexually transmitted infections.

Warnings & Precautions

Nexplanon

Talk to your healthcare provider about using this method of contraception if you have:

  • an allergy to numbing medicines or medicines used to clean your skin;
  • diabetes;
  • high blood pressure;
  • high LDL cholesterol or triglycerides;
  • depressed mood;
  • headaches;
  • kidney problems;
  • gallbladder problems.

Do not use this method of contraception if you:

  • are allergic to anything in this medicine;
  • are pregnant or think you may be pregnant;
  • have breast cancer or any other;
  • had cancer which is sensitive to progestin;
  • have unexplained vaginal bleeding;
  • have a liver tumor;
  • have liver disease;
  • have, or have had blood clots, like – blood clots in your lungs (pulmonary embolism), leg (deep venous thrombosis), heart (heart attack), eyes (total or partial blindness), or brain (stroke).

Note

Unfortunately, this method of contraception doesn’t protect against sexually transmitted diseases.

To lower your chances of getting or spreading STDs, it is recommended to use condoms or female condoms every time you have sex.

Depo-Provera

Do not use this method of contraception if you:

  • have vision problems caused by vascular disease;
  • had breast cancer;
  • have undiagnosed urinary tract or vaginal bleeding;
  • plan a pregnancy in the next few months;
  • have or may have a type of cancer which is dependent on progestin;
  • are allergic to any ingredients of the medication;
  • have liver disease;
  • may be pregnant;
  • have a history of stroke;
  • have a history of blood clots or clotting disorders;
  • have a history of migraines with auras;
  • have a history of heart disease;
  • have a history of heart attack;
  • have risk factors for developing blood clots (such as – genetic changes which cause blood clots, severe high blood pressure, severe cholesterol problems, over age 35, heavy smoker, have blood vessel issues related to diabetes mellitus).

Alcohol

Alcohol does not reduce the effectiveness of these birth control methods, however, alcohol does have an impact on your judgment and behavior.

Drug Interactions

Nexplanon may interact in a negative way with the following medications:

  • topiramate;
  • barbiturates;
  • St. John’s Wort;
  • bosentan (a dual endothelin receptor antagonist that is used in the treatment of pulmonary artery hypertension);
  • rifampin;
  • carbamazepine;
  • phenytoin;
  • oxcarbazepine;
  • griseofulvin;
  • felbamate.

Depo-Provera may interact in a negative way with the following medications:

  • eslicarbazepine;
  • acitretin;
  • enzalutamide (a nonsteroidal antiandrogen medication that is used in the treatment of prostate cancer);
  • aprepitant;
  • diabetes medications (such as – glipizide, chlorpropamide, insulin, metformin, rosiglitazone);
  • aripiprazole;
  • dexamethasone;
  • azole antifungals (such as – itraconazole, voriconazole);
  • deferasirox;
  • barbiturates (such as – phenobarbital, butalbital);
  • dabrafenib;
  • boceprevir (a protease inhibitor used to treat hepatitis);
  • cyclosporine;
  • bosentan;
  • conivaptan;
  • cobicistat;
  • carbamazepine (sold under the tradename Tegretol);
  • clobazam;
  • clarithromycin;
  • cholestyramine.

Breastfeeding

Nexplanon

If you are breastfeeding your infant, you may use this birth control method if 4 weeks have passed since you had your child.

Depo-Provera

Its risk of decreasing milk supply is less than with birth control methods.

Also, it is safe to use while breastfeeding, particularly if started after breastfeeding has been well-established.

Conclusion – Nexplanon vs Depo-Provera

Nexplanon is a brand of implant birth control that is inserted into your arm. The implant is placed subdermally in a quick procedure at the doctor’s office.

It is over 99 percent effective, which actually means that out of 100 women, less than 1 may become pregnant. Advantages of using Nexplanon include:

  • it is easily reversible;
  • it is very convenient;
  • it has no estrogen in it;
  • it is safe to use while you are breastfeeding;
  • it is cost effective over time although the initial cost is high;
  • it is highly effective.

Depo-Provera releases the hormone progestogen into your bloodstream to prevent pregnancy.

The injection acts by thickening cervical mucus to prevent sperm from joining an egg or by preventing the ovaries from releasing an egg.

It starts working within 24 hours of the first shot if injected within 5 days of beginning a period.

About 3 in 100 (3 percent) of women will still get pregnant when using this birth control method. Advantages include:

  • it may help with premenstrual symptoms for some women;
  • it may reduce heavy, painful periods;
  • it is not affected by other medicines;
  • each injection lasts for three months;
  • it is safe to use while you are breastfeeding;
  • you don’t have to remember to take a pill every day;
  • it is an option if you can’t use estrogen-based contraception;
  • it doesn’t interrupt sex.

Image source – Shutterstock

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Sources

https://www.sciencedirect.com/topics/neuroscience/nexplanon
https://academic.oup.com/humrep/article/31/11/2491/2274325