Is Etonogestrel compatible with breastfeeding? Do we have alternatives for Etonogestrel?


March 16, 2018 (Very Low Risk)

Progestin drug that is an active metabolite of desogestrel.
It is used for contraception as subcutaneous implants with a duration of 3 years.

It is excreted into breast milk in small quantities, and, no problems were observed in infants whose mothers used this medication.

Although it is considered safer to start using it after 4-6 postnatal weeks, 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 (Carmo 2017, Lopez 2015, Braga 2015, Phillips 2015, WHO 2015, Mwalwanda 2013, CDC 2013, Gurtcheff 2011).
Only 1 in 100 women using etonogestrel implants may have a significant decrease in milk production (Stuebe 2016).

During lactation progestin-only drugs are preferred or in combination with estrogen for birth control, but whatever is used, the ones with the lower dose of estrogen should be used.
Within the first 6 weeks postpartum, non-hormonal methods are of choise.

Hormone containing contraceptives do not affect the composition of milk, minerals (Mg, Fe, Cu, Ca, P) fat, lactose and calories but only a few the proteins.


Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.


  • Ετονογεστρέλη (Greek)
  • إيتونوجيستريل (Arabic)
  • Этоногестрел (Cyrillic)
  • 依托孕烯 (Chinese)
  • エトノゲストレル (Japanese)
  • C22H28O2 (Molecular formula)


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  2. Stuebe AM, Bryant AG, Lewis R, Muddana A. Association of Etonogestrel-Releasing Contraceptive Implant with Reduced Weight Gain in an Exclusively Breastfed Infant: Report and Literature Review. Breastfeed Med. 2016Abstract
  3. Berens P, Labbok M; Academy of Breastfeeding Medicine. ABM Clinical Protocol #13: Contraception During Breastfeeding, Revised 2015. Breastfeed Med. 2015Abstract Full text (link to original source) Full text (in our servers)
  4. Braga GC, Ferriolli E, Quintana SM, Ferriani RA, Pfrimer K, Vieira CS. Immediate postpartum initiation of etonogestrel-releasing implant: A randomized controlled trial on breastfeeding impact. Contraception. 2015Abstract
  5. Phillips SJ, Tepper NK, Kapp N, Nanda K, Temmerman M, Curtis KM. Progestogen-only contraceptive use among breastfeeding women: a systematic review. Contraception. 2015Abstract Full text (link to original source) Full text (in our servers)
  6. Merk. Implanon. Product Monograph. 2015 Full text (in our servers)
  7. Berens P, Labbok M; Academy of Breastfeeding Medicine. Protocolo clínico de la ABM n.º 13: Anticoncepción durante la lactancia, revisado en 2015. Breastfeed Med. 2015 Full text (link to original source)
  8. Department of Reproductive Health and Research World Health Organization. Medical Eligibility Criteria for Contraceptive Use. WHO/RHR/15.07. 2015Abstract Full text (link to original source) Full text (in our servers)
  9. AEMPS-Merk. Implanon. Ficha técnica. 2014 Full text (in our servers)
  10. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC). U.S. Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm Rep. 2013Abstract Full text (link to original source) Full text (in our servers)
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  12. Mwalwanda CS, Black KI. Immediate post-partum initiation of intrauterine contraception and implants: a review of the safety and guidelines for use. Aust N Z J Obstet Gynaecol. 2013Abstract
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  16. [No authors listed] Intrauterine devices: an effective alternative to oral hormonal contraception. Prescrire Int. 2009Abstract
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  23. Kelsey JJ. Hormonal contraception and lactation. J Hum Lact. 1996Abstract
  24. [No authors listed] Progestogen-only contraceptives during lactation: II. Infant development. World Health Organization, Task Force for Epidemiological Research on Reproductive Health; Special Programme of Research, Development, and Research Training in Human Reproduction. Contraception. 1994Abstract