Etonogestrel

Progestin, active metabolite of desogestrel. It is used as a progestogen-only contraceptive in the form of a subcutaneous implant for 3 years or associated with ethinylestradiol in the form of a vaginal ring 3 out of 4 weeks.

It is excreted in breast milk in negligible amount ^{(Reinprayoon 2000)} and no problems were observed in infants whose mothers used this medication. ^{(Carmo 2017, Bahamondes 2013, Brito 2009, Taneepanichskul 2006)}

Although it is considered safer to start using it after 4-6 postnatal weeks ^{(Berens 2015)}, there have been studies that found that implants applied early in the first days or hours after birth does not affect either production or milk composition and growth of infants. ^{(SMFM 2019, Carmo 2017, Lopez 2015, Braga 2015, Phillips 2015, WHO/OMS 2015, Mwalwanda 2013, CDC 2013, Gurtcheff 2011)}

One in 100 women using etonogestrel implants may have a significant decrease in milk production, so it is advisable to monitor the growth of the infant. ^{(Stuebe 2016)}

During lactation progestin-only contraceptives are preferable to combined with estrogen and, in this case, those with a lower dose of estrogen. ^{(CDC 2016, 2013 y 2010, WHO/OMS 2015, Altshuler 2015, Berens 2015, CLM 2012)}

For the first 4-6 weeks postpartum, non-hormonal methods are the first choice, followed by IUDs and progestogen implants. ^{(Berens 2015, Mwalwanda 2013, Rowe 2013, CLM 2012)}

See below the information of this related product:

• Ethinylestradiol + Etonogestrel (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)