Can a contraceptive implant cause light bleeding?

Question

Hello doctor,

I have been on the Implanon contraceptive for just over a month. I noticed that my vaginal pH seemed off, I had an odor and yellow discharge shortly after getting it. I bled for two weeks, about a month after insertion, then the bleeding stopped for a few days, but I have been bleeding again ever since. The blood is light red with a light flow. I do not have any pain, except for some discomfort around the time I was supposed to get my period.

Can you please help me figure out what is wrong?Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for your detailed description. You are absolutely right to seek guidance. Here is a clinical breakdown of what may be happening with your Etonogestrel implant and your symptoms:

What is normal after Implanon (contraceptive implant) insertion?

During the first three to six months, it is common to experience irregular bleeding or spotting, prolonged or frequent bleeding episodes, and changes in flow (either lighter or heavier). These are expected side effects due to hormonal changes affecting the uterine lining. So, the two-week bleeding episode and ongoing light bleeding may be part of a normal adjustment period.

What is not typical?

Yellow discharge, vaginal odor, and pH imbalance are not typical side effects of Implanon and are more consistent with a vaginal infection.

Possible causes are:

Bacterial vaginosis (BV): Caused by an imbalance in vaginal bacteria. Symptoms include fishy odor, off pH, and thin yellow or gray discharge. Often triggered by hormonal changes (like starting a new contraception).
Trichomoniasis or other STIs (sexually transmitted infections): May cause yellow or green discharge, odor, and itching. Requires specific testing for diagnosis.
Hormonal changes along with secondary infection: Implanon can slightly alter vaginal flora, making you more susceptible to infections.

What should you do?

Visit a doctor or OB-GYN (obstetrician-gynecologist) to request vaginal swab tests (for BV, yeast, and STIs), vaginal pH testing, and possibly a pelvic exam.

Treatment (based on diagnosis):

BV: Treated with Metronidazole (oral or vaginal gel).
STIs: Treated with specific antibiotics or antiparasitic medications.
No infection found: Symptoms may be hormone-related and could resolve on their own.
Regarding the bleeding: If irregular bleeding continues beyond three months or affects your quality of life, your doctor might recommend a short course of combined oral contraceptives to stabilize bleeding or switching to a different contraceptive method if symptoms persist.

In summary, irregular bleeding is likely a normal side effect during the first few months after starting a contraceptive implant, as your body adjusts to the hormonal changes. However, the presence of vaginal odor and yellow discharge is not typical and may indicate an infection, such as bacterial vaginosis (BV) or another type of vaginal infection. The best next step is to see a healthcare provider for testing and, if necessary, treatment. Once any underlying infection is addressed, the bleeding pattern may improve over time.

I hope this helps you.

Thank you.