The birth control implant, commonly known by the brand name Nexplanon, is a highly effective form of long-acting reversible contraception (LARC). This small, flexible rod is inserted under the skin of the upper arm and works continuously to prevent pregnancy for its approved duration. If you discover that your implant has passed its expiration date, the protection offered by the device is finite. Its effectiveness diminishes as it nears and passes the scheduled removal date.
Understanding the Decline in Hormone Protection
The implant prevents pregnancy by steadily releasing the synthetic hormone etonogestrel into the bloodstream. This progestin hormone primarily works by suppressing the body’s natural ovulation cycle, preventing an egg from being released by the ovary. Additionally, etonogestrel thickens the cervical mucus, creating a barrier that makes it difficult for sperm to travel through the cervix.
The U.S. Food and Drug Administration approves the implant for three years of continuous use, and its efficacy is over 99% during this period. While the hormone levels gradually decrease, they generally remain high enough to consistently suppress ovulation. The expiration date marks the point at which the manufacturer can no longer guarantee the hormone concentration is sufficient to provide reliable contraception.
Once the implant expires, the etonogestrel levels in your body drop rapidly, and the contraceptive effect is lost. This decline means the suppression of ovulation may cease, allowing your natural fertility cycle to resume. The return of fertility can be swift, potentially starting as early as the first week after the loss of efficacy. Therefore, any sexual activity occurring after the expiration date carries a significant risk of pregnancy.
Immediate Action Steps to Prevent Pregnancy
If you realize your implant has expired, your first and most immediate step should be to use a barrier method, such as a condom, for every instance of sexual intercourse. This short-term measure is necessary to prevent sperm from entering the reproductive tract while you arrange for a long-term solution.
For any unprotected sexual activity that occurred around or after the expiration date, emergency contraception (EC) is a consideration. The most widely available option is levonorgestrel (Plan B), an over-the-counter pill most effective when taken within 72 hours (three days). Its effectiveness decreases the longer you wait and may be reduced for individuals with a higher body mass index.
A more potent EC option is ulipristal acetate (Ella), which requires a prescription but remains highly effective for up to 120 hours (five days). Ulipristal acetate is generally considered more effective than levonorgestrel, particularly when taken closer to the five-day mark. You should contact a healthcare professional right away to discuss which form of emergency contraception is most appropriate for your specific circumstances.
The Removal and Transition Process
The next priority is to contact your healthcare provider to schedule an appointment for the removal of the expired device. Even though the implant no longer provides effective birth control, it must still be removed by a trained professional. This procedure involves a small incision under local anesthesia and is typically a quick and simple process.
At this removal appointment, you have the option to transition immediately to a new contraceptive method. The simplest transition is to have a new implant inserted simultaneously, which ensures continuous, seamless protection. This simultaneous removal and insertion is the most straightforward way to maintain long-acting contraception.
Alternatively, you may decide to switch to a different form of birth control, such as an intrauterine device (IUD), the birth control pill, or the contraceptive shot. If you choose a new method, you must continue using a backup method, like condoms, until your new form of contraception is established and confirmed to be providing protection. Your healthcare provider will specify this timeline during your visit.