Learn more: Bleeding with the Implant

It is not uncommon to have times of frequent bleeding with the implant. About 1 in 4 users will experience this pattern.

It happens because the medication inside the implant causes the lining of the uterus to become very thin and at times, unstable. The bleeding that occurs can be annoying but does not usually cause significant blood loss.

Frequent bleeding with the implant is likely to go away on its own. But, if it is bothersome to you, then it is time to consider what needs to be done to make it go away.

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The first step:

Call our clinic or send a MyChart message to tell us about your concerns. Depending on your medical history, we may ask that you come into the lab for testing.

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The next step:

If you want, consider medications to treat bleeding.

• Anti-inflammatory medication, like ibuprofen, has been shown to reduce bleeding with the implant. If this is a safe medication for you to take, we recommend that it be the first medication that you try. A common recommend dose is over-the-counter ibuprofen 600-800mg every 6-8 hours for 5 days in a row.

If the ibuprofen does not help, here are the next options (which will require a prescription). It is OK to try one medication, and if that does not work, try another one:

• Tamoxifen 10mg in morning and night for 7 days. This medication is safe and does not have side effects. It stimulates the estrogen receptors in the lining of the uterus which can make the bleeding stop while using the medication and after taking it. If it helps with bleeding, it is safe to repeat the dose as often as one time per month if bleeding happens again.
• A birth control pill, patch, or ring. These medications work because they contain estrogen which stabilizes the lining of the uterus. They can be used for 1 month, 3 months, or longer when using the implant. At any time, you can go off and see if it is still needed.
• Norethindrone acetate 5 mg each day. This is a progestin-only medication that stabilizes the lining of the uterus. It can be used for 1 month, 3 months, or longer when using the implant. At any time, you can go off and see if it is still needed.
• Other medication that we may recommend are doxycycline (an antibiotic) and tranexamic acid, a medication that reduces menstrual bleeding. There is less research to show that these medications will reduce bleeding with the implant, but they are safe to try for most people.