If your Nexplanon has passed its expiration date, it doesn’t stop working like a switch being flipped. The implant releases hormones on a gradually declining curve, so some contraceptive effect likely remains for a period after expiration. But the protection is no longer guaranteed, and pregnancy becomes possible. The FDA approves Nexplanon for up to 5 years, and the manufacturer states it must be removed no later than the end of that fifth year.
How the Implant Works as It Ages
Nexplanon works by steadily releasing a synthetic hormone called etonogestrel into your bloodstream. This hormone prevents your ovaries from releasing eggs and thickens your cervical mucus so sperm can’t easily reach an egg. The amount of hormone released decreases over time: about 60 to 70 micrograms per day in the first weeks, dropping to roughly 35 to 45 micrograms by the end of year one, 30 to 40 micrograms by year two, and 25 to 30 micrograms by the end of year three.
The FDA doesn’t publish specific release rates for years four and five, but the pattern is clear: hormone output keeps declining. At some point, the levels drop low enough that your body may begin ovulating again. That’s why Nexplanon carries a hard stop at five years. While some residual hormone remains in the rod beyond that window, the amount may not be enough to reliably suppress ovulation in every person.
Your Pregnancy Risk After Expiration
When used within its approved timeframe, Nexplanon is more than 99% effective at preventing pregnancy. After the five-year mark, that number is no longer guaranteed. NHS Scotland guidelines describe the risk of pregnancy in the fourth year (under the older three-year approval window) as “low,” which suggests the implant doesn’t lose all effectiveness overnight. But “low risk” is not the same as “protected,” and there is no reliable data telling you exactly how much protection remains in your specific case once the implant has officially expired.
If you’ve had unprotected sex with an expired implant still in place, the most practical step is to use emergency contraception. A copper IUD is the most effective option and can be placed up to five days after intercourse. Hormonal emergency contraception pills are also available, though their interaction with the residual hormones from an expired implant isn’t well studied. If you’re unsure whether your implant has expired and you’ve been sexually active, a pregnancy test is a reasonable first move.
Ectopic Pregnancy: A Specific Concern
The manufacturer warns that if you do become pregnant with an expired implant still in your arm, there is a heightened concern for ectopic pregnancy. This is when a fertilized egg implants outside the uterus, most commonly in a fallopian tube. It’s a medical emergency. The residual low-dose hormones from the implant may alter how a fertilized egg travels, increasing this risk. Lower abdominal pain, especially on one side, combined with a missed period or a positive pregnancy test, should prompt immediate medical attention.
Changes You Might Notice
As hormone levels from the implant drop, your body begins transitioning back toward its natural hormonal patterns. For many people, this means changes in bleeding. During the active life of the implant, bleeding tends to become lighter over time. Higher hormone levels in the earlier months are actually associated with more unpredictable and prolonged bleeding, while the lower levels later on often bring more stable (and lighter) patterns.
Once the implant is truly running low or has expired, you may notice your periods becoming more regular again, or you might experience irregular spotting as your body adjusts. Some people notice the return of symptoms that the implant had been suppressing, like heavier periods, cramping, or PMS. These shifts are signs that the implant’s hormonal effect is waning.
How Quickly Fertility Returns After Removal
One of the notable features of the implant is how fast fertility bounces back. It’s possible to get pregnant right away after removal. Unlike some other hormonal methods that can delay ovulation for weeks or months, the implant’s hormone clears your system quickly once the rod is out. If you’re getting your expired implant removed and don’t want to become pregnant, you’ll need another contraceptive method in place immediately, whether that’s a new implant inserted at the same appointment or a different method started the same day.
What To Do With an Expired Implant
If your Nexplanon has passed the five-year mark and it’s still in your arm, it needs to come out. Leaving it in indefinitely isn’t recommended. The manufacturer specifically warns that failure to remove the implant can result in “compromised fertility, ectopic pregnancy, or persistence or occurrence of a drug-related adverse event.” The removal procedure itself is quick, typically taking just a few minutes under local anesthesia. A new implant can be placed through the same small incision if you want to continue with this method.
If you’re a few weeks or even a couple of months past the expiration and haven’t had a chance to schedule removal yet, use backup contraception like condoms in the meantime. Don’t assume the implant is still covering you. And if you want a new implant, most providers can do the swap in a single visit, so there’s no gap in protection if you time it right.