Starting the etonogestrel implant
Etonogestrel implants can be inserted at any stage of the menstrual cycle. If pregnancy cannot be excluded (for general advice about excluding pregnancy, see Starting intrauterine contraception), a follow-up pregnancy test is recommended 4 weeks after insertion, or 3 weeks after insertion if no further episodes of unprotected sex occurred in the first week of use.
The etonogestrel implant is immediately effective if:
- inserted on day 1 to 5 of a regular menstrual cycle
- inserted less than 21 days postpartum
- inserted within 5 days of an abortion
- replacing an etonogestrel implant
- switching from depot medroxyprogesterone injections
- switching from a copper IUD during days 1 to 5 of a regular menstrual cycle.
The etonogestrel implant takes 7 days to become effective if inserted at all other times, and if the current method of contraception is not effective at the time of switching (eg late doses, injection or replacement).
If switching from a combined oral contraceptive or vaginal ring, continue active hormone pills or the vaginal ring for a further 7 days after insertion to prevent potential pregnancy from previous intercourse. For more information about time to effectiveness when switching between contraceptive methods, see printable table.
Clinicians must be trained in correct insertion technique; deep insertion can result in implant migration. The recommended site of insertion is over the triceps (away from the sulcus) in the nondominant arm1. Use:
etonogestrel 68 mg implant subdermally. Replace every 3 years. contraception etonogestrel
Follow-up after insertion of the etonogestrel implant is only required if the patient is experiencing method-related concerns (eg impalpable implant).