What is the duration for return of menstruation after removal of Nexplanon (etonogestrel implant)?

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From the Guidelines

After Nexplanon removal, menstruation typically returns within 2-4 weeks for most women. The timeframe for menstruation to return can vary significantly based on individual factors, such as age, overall health, and the duration of Nexplanon use 1. Some women may experience their period as soon as a few days after removal, while others might wait up to 3 months for their cycle to normalize.

Factors Influencing Menstrual Return

  • The delay in menstruation return occurs because Nexplanon works by releasing etonogestrel, a form of progestin, which suppresses ovulation and thins the uterine lining 1.
  • Once removed, the body needs time to clear this hormone from the system and resume normal hormonal cycling.
  • Individual factors such as natural cycle patterns before Nexplanon use also influence how quickly periods return.

Post-Removal Considerations

  • If concerned about pregnancy prevention after removal, it is essential to use an alternative contraceptive method immediately, as fertility can return quickly—sometimes before the first visible period.
  • If menstruation hasn't returned after 3 months, it is crucial to consult a healthcare provider to rule out pregnancy or other health issues. The information provided in the study 1 focuses on the benefits and implementation of postpartum long-acting reversible contraception, including Nexplanon, but does not directly address the return of menstruation after removal. However, understanding how Nexplanon works and its effects on the body helps in estimating the timeframe for menstrual return.

From the Research

Return of Menstruation after Nexplanon Removal

  • The time it takes for menstruation to return after Nexplanon removal can vary from woman to woman 2.
  • A study on etonogestrel implant users found that ulipristal acetate reduced the number of bleeding days in a 30-day period, but it did not provide information on the return of menstruation after implant removal 2.
  • Another study on the effect of different oral dosages of levonorgestrel on ovarian activity found that most subjects ovulated during the post-treatment period, but it did not specifically address the return of menstruation after Nexplanon removal 3.
  • There is limited research available on the exact timeline for the return of menstruation after Nexplanon removal, but it is known that hormonal drugs like progestins can affect menstrual cycles 4.
  • The return of menstruation after stopping hormonal contraception can take several months, and it may be influenced by individual factors such as age, weight, and overall health 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Hormonal drugs for the treatment of endometriosis.

Current opinion in pharmacology, 2022

Research

The combined contraceptive vaginal device (NuvaRing): a comprehensive review.

The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 2005

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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