Subcutaneous long-acting hormonal implant (LARC)
ATC code: G03AC08 (Etonogestrel)
Flexible 4 cm plastic rod with 68 mg etonogestrel. Releases 60-70 µg/day in year 1, 30-40 µg by year 3. Suppresses ovulation via LH suppression. Three-year duration. Pearl Index 0.05 – the most effective reversible method after sterilization. Independent of pill-taking or memory.
First line
Long-acting reversible contraception (LARC) for 3 years. Per SEGO 2023 and FSRH 2017, first-line for women of any age, including teens. Suitable with estrogen contraindications, breastfeeding, or forgetfulness. Insertion takes 1-3 minutes in office under local anesthesia.
First line
Contraception during breastfeeding. MEC 2015 category 1 from day 1 postpartum (category 2 if inserted in first 3 weeks – minimal theoretical risk, acceptable in practice). Etonogestrel does not reduce milk supply, RID about 0.2%. Ideal for women who don't want daily pill-taking.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Remove if pregnant.
WHO MEC 2015 category 1 from day 1 postpartum. Etonogestrel does not reduce milk supply. RID about 0.2%, Hale L1. Ideal choice for breastfeeding women.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Etonogestrel (implant) is evaluated for the following indications with varying evidence strength: Contraception (evidence tier A), Contraception during breastfeeding (evidence tier A). See the full indication matrix with dosing and citations above on this page.
Common side effects of Etonogestrel (implant) (≥ 1 in 100): Cycle changes, Acne (15%), Weight gain 1-3 kg, Headache, Breast tenderness, Decreased libido. See the Safety section for uncommon and serious reactions.
FDA category X. Remove if pregnant.
WHO MEC 2015 category 1 from day 1 postpartum. Etonogestrel does not reduce milk supply. RID about 0.2%, Hale L1. Ideal choice for breastfeeding women.
Etonogestrel (implant) is contraindicated in: Hypersensitivity; Active VTE; Severe hepatic impairment, liver tumors; Breast cancer; Pregnancy. Full list in the Safety section.