Hi, The lack of menstruation and spotting after the expiration of the Implanon could be due to a variety of factors. Implanon is a form of contraception that contains the hormone progestin, which can cause irregular bleeding. Once the Implanon has expired, it is no longer effective in preventing pregnancy, but it can still cause hormonal imbalances that may affect menstrual cycles. Another possible cause of the irregularity could be an underlying medical condition, such as polycystic ovary syndrome (PCOS) or thyroid dysfunction. These conditions can affect hormonal balance and cause menstrual irregularities. However, it is important to note that irregular periods can be normal for some women, and the absence of a period does not always indicate a medical problem. If you have concerns about your menstrual cycle or the expired Implanon, it is important to speak with a healthcare provider. They may recommend testing for underlying medical conditions or suggest a different form of contraception. If you cannot afford to have the Implanon removed, some healthcare providers may offer free or low-cost options. It is important to note that while you may not be experiencing pregnancy symptoms, it is still possible to become pregnant even with irregular menstrual cycles. Therefore, it is important to consider using a form of contraception to prevent unwanted pregnancy. If you require a personalized response, kindly use the Ask A Doctor service and post a follow-up. Take care. Hope I have answered your question. Regards, Dr. Priyanka, General & Family Physician