Birth control implant (Nexplanon) removal: Side effects & when will I get my period back?

Keep in mind that your experience may vary depending on where you live and the type of implant you’re using. It’s always important to follow your doctor’s advice and speak to them directly if you have specific questions about your birth control method.

When to get the implant removed

The Nexplanon implant will protect against pregnancy for up to 5 years before it must be removed. You can also have the implant removed earlier if you are planning pregnancy, changing to a different hormonal contraceptive, or want to switch to a non-hormonal option such as Natural Cycles. 

If the implant worked for you and you’d like to keep using it, you can have a new one inserted at the same time as the old one is removed. 

What does Nexplanon removal feel like?

Having the implant (Nexplanon) removed is a relatively straightforward and fast procedure. It takes a little longer than insertion, but is usually completed in less than five minutes. The process will go something like this [1, 2, 3]:

• As with insertion, the practitioner will ask you to lie on your back with your arm out to the side and bent at the elbow, giving them easy access to the implant area.
• They will feel your arm to locate the implant.
• The practitioner will give you a shot or spray of an anesthetic to numb the area, which takes one to two minutes to take effect.
• Once your arm is numb, the practitioner will make a small incision to remove the implant. 
• They’ll push the implant towards the incision, then grab it with a small pair of forceps and pull it out.

Depending on whether you get the anesthesia as a spray or an injection, you might feel a brief cool or stinging sensation. But it shouldn’t hurt when the incision is made or when the implant is removed, but you may feel some pressure in the area [2].

Very rarely, in around 9 in 1000 cases, the implant may be inserted deeper than intended, or its position may shift, making it more difficult to remove. In those cases, the implant might need to be removed by a specialist healthcare provider trained in more complex implant removals [2]. 

Nexplanon removal aftercare

After removal is complete, your practitioner will cover the incision with an adhesive dressing and, if necessary, paper stitches before you leave. Keep these dry and do not remove them until the cut has healed, to prevent infection [2]. 

Once the anesthesia wears off, you might have some tenderness in the area. It is also common to have some bruising that may last one or two weeks. But you should have no issues moving the arm or driving after your appointment. Occasionally, some individuals experience tingling or “pins and needles” in their arms, but this usually resolves after a few hours or days [2].

Implant removal side effects

If you replace your implant, you are unlikely to experience any side effects beyond minor bruising at the implant site. Otherwise, if you do not replace the implant or use alternative hormonal birth control, you might experience hormonal side effects. 

The implant works by releasing a progesterone-like hormone called etonogestrel to suppress ovulation [3]. After removal of the implant, any side effects you experienced from the etonogestrel, such as weight gain, acne, and reduced libido, should subside as your natural hormones rebalance again.

Your menstrual cycle will also begin to return to its usual rhythm, and your period will start again. Any bleeding you experience while using the implant is not a true period — it's unscheduled bleeding (sometimes called breakthrough bleeding or spotting). Ovulation is the driver of the menstrual cycle, and once this returns to normal, your periods will begin again. In the meantime, you may notice some spotting, and your periods may be irregular while your body adjusts. 

There is no specific time frame for when ovulation or your period will occur again. One study found it took an average of two cycles for fertility to return to normal after implant removal, while the FDA advises pregnancy can occur within one week [1, 5]. If you are trying to avoid pregnancy, you should immediately begin using another form of contraception, such as condoms, when having sex.

When to see a doctor

You must never try to remove the implant yourself. Nexplanon removal should always be carried out by a healthcare professional. Depending on your location, removal may be done by your doctor, OB-GYN, local health center, or sexual health clinic. Always speak to a healthcare practitioner if:

• You are coming to the end of the five-year lifespan of your implant (or sooner if your doctor advises)
• You have had the implant removed and notice signs of infection at the cut site, such as redness or swelling
• You’ve had unprotected sex after getting the implant removed and want emergency contraception
• You have the implant removed, and your period hasn’t returned after three months [6]

Go hormone-free with Natural Cycles

Whether you want to try a hormone-free birth control option or are ready to plan a pregnancy, Natural Cycles is here with you every step of your journey. Our FDA-cleared app uses a special algorithm, along with biomarker data, to predict when you are likely to ovulate and when your fertile window is. 

If you are using NC° Plan Pregnancy, the app will show you which days you have the best chance of getting pregnant. On the flip side, if you are using NC° Birth Control, the app will show you which days to avoid (your fertile days) and which are safest to have unprotected sex without getting pregnant. You can also track symptoms, such as PMS, spotting, and discharge, and read a report on your cycle length and characteristics, helping you feel more empowered in your fertility and sexual health.