The etonogestrel implant (Nexplanon) is a long-acting reversible contraceptive method that prevents pregnancy by releasing a synthetic progestin hormone for up to three years. Deciding to have the implant removed marks a significant transition, whether the goal is to switch contraception or to try for conception. Understanding the physical and hormonal adjustments involved can help manage this period successfully.
The Removal Procedure and Immediate Site Care
The removal of the implant is a minor surgical procedure performed in a healthcare provider’s office. A local anesthetic is injected into the upper arm where the implant is located. A small incision is then made near the tip of the implant, which is gently guided out with specialized instruments.
Following the procedure, the site is closed with steri-strips or a single stitch and covered with a small bandage. A pressure bandage is often applied over the area to help minimize potential bleeding and bruising, which should be kept on for at least 24 hours. Bruising, tenderness, and minor swelling at the removal site are common and generally resolve within a few days to a couple of weeks. The smaller bandage should remain in place for three to five days, and it is important to keep the site clean and dry during this time to prevent infection.
Return of Menstruation and Fertility
The etonogestrel hormone clears from the body quickly after removal, meaning fertility can return almost immediately. It is possible to become pregnant as early as a week after the implant is taken out. Ovulation typically resumes within two to six weeks for most individuals.
The menstrual cycle usually returns within one to three months after removal. The first few periods may look different than expected, especially if the implant caused very light or absent bleeding during use. Initial post-removal periods may be heavier or lighter than your pre-implant cycles, and some individuals report temporary irregular bleeding or spotting. It can take a few months for your body’s natural hormonal rhythm to re-establish itself and for cycles to normalize.
Navigating Post-Removal Hormonal Shifts
As the body adjusts to the absence of the synthetic progestin, many people experience systemic changes as their natural hormone production restarts. Mood fluctuations, including temporary irritability, anxiety, or general mood swings, are frequently reported as hormone levels recalibrate. These emotional adjustments are a common aspect of returning to a natural hormonal state.
Changes to the skin and hair are also possible during this adjustment phase. While on Nexplanon, some individuals may have experienced improved skin, and its removal can sometimes lead to a temporary acne flare-up as androgens become more active. Other physical adjustments can include temporary changes in libido, breast tenderness, or headaches. Metabolism and appetite may also shift, potentially leading to weight fluctuations, either a gain or loss.
Most post-removal symptoms tend to subside within one to two months, though some may linger for up to three months as the system fully adjusts.
Planning for Future Contraception or Conception
Given the immediate return of fertility after Nexplanon removal, a plan for preventing pregnancy is essential if conception is not desired. The swift return of ovulation means that a new contraceptive method should be initiated immediately, either on the day of removal or soon after. Barrier methods, such as condoms, or starting another hormonal method, like the pill, are necessary to maintain pregnancy protection.
For those planning to try for conception, the quick return of fertility is beneficial. While trying can begin immediately, some healthcare providers recommend tracking cycles for a few months to better understand ovulation timing. This period allows the menstrual cycle to normalize, making it easier to accurately track fertile windows and time attempts at conception. Consulting with a healthcare provider can provide personalized advice on preparing the body for pregnancy, such as starting prenatal vitamins.
Monitoring your body’s changes and communicating any persistent or concerning symptoms with your healthcare provider will ensure a smooth transition.