Idiopathic intracranial hypertension (IIH), a severe neurological condition in which pressure on the brain suddenly increases, has been linked to hormone-based contraceptives. In patients with IIH, the brain is affected in a way that mimics – but is not – a large brain tumor.
What is Nexplanon?
Nexplanon is a small plastic implant that is inserted under the skin of the upper arm to prevent pregnancy for up to 3 years. The Nexplanon implant is approximately 4 cm x 2 mm. The device contains etonogestrel, a synthetic hormone, which is released into the bloodstream to protect against pregnancy. Nexplanon is manufactured by Merck & Co., and was approved by the U.S. Food & Drug Administration (FDA) in 2006.
Birth Control and Idiopathic Intracranial Hypertension
IIH occurs when cerebrospinal fluid builds up inside the skull, causing symptoms that are similar to those of a large brain tumor. IIH may be caused by an increase in fluid production or decrease in its absorption.
It is still not clearly understood why the condition occurs in many patients. However, certain medications including hormone-based contraceptives have been associated with idiopathic intracranial hypertension. One hormone in particular, a progestin called levonorgestrel, was linked to the disorder in 1995. IIH has also been referred to as pseudotumor cerebri and benign intracranial hypertension.
Symptoms of idiopathic intracranial hypertension include:
- Changes in vision
- Vision loss
- Papilledema (swelling of the optic nerve)
- Feeling dizzy or nauseated
- Neck stiffness
- Difficulty walking
- Persistent ringing in the ears (tinnitus)
Treatment is centered around the cause of idiopathic intracranial hypertension. If, for example, it has been determined that the problem was caused by a hormonal contraceptive like Nexplanon, the patient’s doctor will likely recommend quitting the drug in favor of one with fewer potential side effects. However, never stop taking a prescription medication without consulting your physician first.
Other IIH treatments include:
- Fluid or salt restriction
- Corticosteroids, acetazolamide or furosemide
- Shunting to relieve pressure from the buildup of cerebrospinal fluid
- Surgery to relieve pressure on the optic nerve
- Weight loss