Brief Answer: This is not uncommon. Detailed Answer: Hi XXXXXXX Thanks for the query. I understand your problem. Changes in menstrual pattern are common after using long acting birth control hormones like the nexplanon. Some women experience absent menses or spotting while some bleed heavily. So bleeding changes are expected. Unfortunately you are experiencing heavy bleeding or menorrhagia in medical terms and it tends to disrupt normal functioning. Also, you are having severe pain and the color of blood is dark brown. In this case, other causes like a possible pregnancy or any other cause in the genital tract needs to be evaluated. It would help to know the date of the first day of your menstrual cycle before insertion of the implant, on which day of the menses the implant was implanted and if you were using any other contraceptive before this? For now, I suggest that you get a home pregnancy test done to rule out an accidental pregnancy as this is one thing that must be cleared first. If it is negative, than the bleeding is most likely due to the implant and it tends to settle down in a 1-2 months. If the bleeding is very heavy, drugs like mefenamic or tranexamic acid tablets taken either every 8 or 12 hours [depending upon the severity of bleed] help to control bleeding. Than watch for the next 1-2 bleeding patterns. If heavy bleeding continues, a pelvic examination by a gynecologist and an ultrasound are needed to check if any other cause like a fibroid or a polyp are causing the bleeding. If there is no other cause and bleeding continues, you can try using the tranexamic acid tablet whenever there is bleeding or may even need to remove the implant. Please do not worry as implants do cause bleeding issues and they tend to settle down after some time. Hope you find this useful. I would be glad to provide answers to any further queries. Thanks for using XXXXXXX Have a good day! Dr. Madhuri Bagde Consultant Obstetrician and Gynecologist

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