Advantages and disadvantages of the etonogestrel implant

Advantages and disadvantages of the etonogestrel implant are listed in Advantages and disadvantages of the etonogestrel implant. Also consider other factors affecting choice of contraceptive method.

Table 1. Advantages and disadvantages of the etonogestrel implant

Advantages

extremely effective (99.95%)

minimal user involvement—beneficial if compliance may be difficult (eg in adolescence)

long acting (effective for 3 years)

high continuation rates (70 to 82% at 1 year)

cost-effective

no adverse effect on bone mineral density, so can be used first line in adolescents and perimenopausal individuals

suitable for Quick Start

safe to use immediately postpartum and during breastfeeding

few contraindications and precautions, and few serious risks associated with use; may be an alternative when estrogen is contraindicated

induces amenorrhoea in around 22% of users

may improve dysmenorrhoea

ovulation is restored within weeks of implant removal

available on the PBS but cost of insertion varies with the provider

Disadvantages

altered bleeding patterns

requires a procedure for insertion

deep insertion can result in implant migration

scarring at the implant site

drug interactions

benign ovarian cysts

other adverse effects [NB1] [NB2]:

  • headaches
  • mood changes [NB3]
  • weight gain
  • breast tenderness
  • loss of libido
Note:

PBS = Pharmaceutical Benefits Scheme

NB1: These adverse effects have been reported by users of all forms of progestogen-only contraception, but evidence is insufficient to prove a causal effect. Many resolve within 3 months of starting the contraceptive.

NB2: Acne may worsen or improve in users of the etonogestrel implant.

NB3: An association between first prescription of an antidepressant and contraceptive use has been seen, but a causal link is not proven.