Nexplanon is a long-acting reversible contraception (LARC), a highly effective birth control method. It is a small, flexible rod about the size of a matchstick, which a healthcare professional inserts discreetly under the skin of the upper arm to prevent pregnancy.
The Science Behind Nexplanon’s Duration
Nexplanon works by releasing a continuous, low dose of etonogestrel, a synthetic progestin hormone. This hormone prevents pregnancy by inhibiting ovulation, thickening cervical mucus to block sperm, and thinning the uterine lining to affect implantation. The implant contains a finite amount of etonogestrel, released gradually over time. Hormone release is highest initially and then decreases, maintaining sufficient levels for contraception. This controlled release means the implant has a specific lifespan.
Approved Duration and Extended Use Guidance
The U.S. Food and Drug Administration (FDA) officially approves Nexplanon for three years of use. This approval is based on clinical trials demonstrating high efficacy throughout this period. The manufacturer also states the implant must be removed by the end of the third year.
Research and clinical experience suggest Nexplanon can be effective for a longer duration. Studies show continued effectiveness for up to five years, with no reported pregnancies in some cohorts during the fourth and fifth years. These studies indicate hormone levels may remain sufficient to prevent ovulation beyond three years for many individuals. While some healthcare providers may offer extended use, this decision should always be made in consultation with a healthcare professional. Guidelines for extended use can vary by region and may change as more data becomes available.
What Happens When Use Extends Beyond Approved Time
When a Nexplanon implant remains in place beyond its three-year approved period, the amount of etonogestrel released gradually diminishes. This decline can compromise its contraceptive effectiveness. While research suggests it may remain effective for up to five years, individual responses vary, and the risk of unintended pregnancy increases as the implant ages.
Leaving the implant in for an extended period might lead to other considerations. Changes in menstrual bleeding patterns are a common side effect, and these can become more irregular over time. There is also a slight chance of the implant being harder to remove due to tissue growth or migration. If pregnancy occurs with an expired implant, there is a slightly higher chance of it being an ectopic pregnancy.
Timely Removal and Next Steps
Prompt removal of the Nexplanon implant at or before the end of its recommended use period is important. A healthcare professional performs this minor outpatient procedure in an office setting. The process involves numbing the area, making a small incision, and gently removing the rod, usually taking only a few minutes.
After removal, individuals have several options for continued family planning. A new Nexplanon implant can be inserted immediately in the same arm. Alternatively, individuals can switch to a different birth control method or plan for pregnancy. Fertility returns rapidly once the implant is removed. Proactively scheduling the removal appointment ensures continuous contraceptive protection or a smooth transition.