Nexplanon Is Now Approved for 5 Years: What Women Need to Know

You got your implant placed three years ago and you've been mentally preparing for the removal appointment. Then a friend texts you: apparently it's been approved for five years now. You go looking for information and find mostly news headlines, nothing that actually explains what changed or what it means for you specifically.

Here's what the trial actually showed, and what questions are worth asking your OB-GYN.

What the extension trial actually tested

The study enrolled 399 women who had already been using Nexplanon for 36 months. They continued for an additional 24 months, with pregnancy monitoring throughout. The Pearl Index — the standard measure of contraceptive effectiveness, expressed as pregnancies per 100 women per year of use — was 0.0 for both year 4 and year 5.

The safety profile during years 4 and 5 matched the first three years closely. No new adverse events emerged. The most common side effect was irregular bleeding: some women had more spotting, some had less frequent periods, some had neither. This is the same pattern seen throughout Nexplanon's existing use.

One detail worth noting: the trial included women across a wide BMI range, including 38% with a BMI of 30 or above. Contraceptive research has historically enrolled mostly average-weight participants, which creates real questions about effectiveness in higher-weight women. The Nexplanon data, across both the original trial and the extension, held consistent across weight categories.

What this means if you have one in now

The approval applies to implants currently in use, not just newly placed ones. If you had your implant inserted before January 2026, you may be eligible to leave it in for up to five years from the insertion date, subject to your doctor's assessment.

The key variable is when it was placed. The hormone reservoir in the implant — etonogestrel, a synthetic progestin — releases at a consistent rate over time. The trial confirmed that the release is effective and safe through year 5. If your implant is currently in year 3, you now have the option to discuss leaving it for another two years rather than replacing it.

There is one caveat: some women experience changes in bleeding patterns between years 3 and 5. The FDA approval doesn't guarantee your implant will feel exactly the same after year 3 — it confirms that contraceptive efficacy and safety are maintained. Any changes in side effects worth flagging are worth discussing with your OB-GYN.

What to tell your OB-GYN

• 💬 Bring your insertion date. The 5-year clock runs from placement, not from the January 2026 approval. Your provider can tell you exactly where you are in that window.
• 💬 Ask whether the REMS-trained clinician requirement applies to your clinic for removal and any re-insertion — this is a new requirement as of February 2026.
• 💬 If your periods have changed significantly in the past year, bring that up. Irregular bleeding is the most common reason women choose to remove their implant before the approved end date.
• 💬 If you're planning pregnancy within the next two years, removal timing matters. Fertility typically returns within weeks of removal — discuss timing based on your specific plans.