What Happens If You Don't Remove Nexplanon
Keeping Nexplanon past its recommended three-year window can lower its contraceptive effectiveness and increase the likelihood of side effects. The implant is designed for short-term use, and manufacturers do not recommend leaving it longer without discussing risks with a clinician.
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Effectiveness Drops Over Time
Nexplanon releases a steady, low dose of etonogestrel, but the hormone reservoir depletes as the implant ages. After three years, pregnancy prevention is no longer guaranteed, and the device is not studied or approved for extended use beyond that point.
Escalating Hormonal Side Effects
Prolonged exposure to the progestin in Nexplanon can worsen common side effects, including irregular bleeding, spotting, acne, mood changes, weight gain, and headaches. Some people also report persistent changes in libido or breast tenderness the longer the implant stays in place.
Insertion-Site and Removal Risks
Over time, the implant can become more difficult to locate and remove. Scar tissue may form around it, and migration or deep embedding can occur, making a simple in-office removal more complicated and sometimes requiring imaging or a minor procedure.
When to Remove Nexplanon
Schedule removal as the three-year mark approaches, or sooner if side effects become intolerable. A healthcare provider can confirm the implant's position, discuss alternative contraception, and perform the removal quickly, often during the same visit.
| Timeframe | What to Expect |
|---|---|
| 0–3 years | Approved use period; effective pregnancy prevention |
| Past 3 years | Effectiveness not guaranteed; side effects may increase |
| Removal timing | Plan removal before or shortly after the 3-year mark |
Signs You Should Seek Removal Sooner
- Persistent or heavy irregular bleeding
- New or worsening mood symptoms
- Pain, swelling, or hardness at the implant site
- Suspected pregnancy
- Difficulty feeling or locating the implant