What do I need to know about the etonogestrel-relesasing contraceptive implant (Nexplanon)?

Despite ENG implant being used internationally for two decades, many Canadian providers have not had any exposure during their training. As education and awareness grows, we hope to see an increase in LARC use attributable to the implant in coming years. While Health Canada has not authorized the use of Nexplanon in patients under the age of 18, based on this population being excluded from the initial safety trials, there is no biologically plausible reason to restrict the device from menstruating adolescents following an informed consent discussion. Funding: There are no funders to report for this manuscript. Potential Conflicts of Interest: All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

- 1.Di Meglio G, Crowther C, Simms J. Contraceptive care for Canadian youth. Paediatr Child Health 2018;23(4):271–7. [DOI] [PMC free article] [PubMed] [Google Scholar] - 2.Palomba S, Falbo A, Di Cello A, Materazzo C, Zullo F. Nexplanon: The new implant for long-term contraception. A comprehensive descriptive review. Gynecol Endocrinol 2012;28(9):710–21. [DOI] [PubMed] [Google Scholar] - 3.Xu H, Wade JA, Peipert JF, Zhao Q, Madden T, Secura GM. Contraceptive failure rates of etonogestrel subdermal implants in overweight and obese women. Obstet Gynecol 2012;120(1):21–6. [DOI] [PMC free article] [PubMed] [Google Scholar] - 4.Carvalho N, Margatho D, Cursino K, Benetti-Pinto CL, Bahamondes L. Control of endometriosis-associated pain with etonogestrel-releasing contraceptive implant and 52-mg levonorgestrel-releasing intrauterine system: Randomized clinical trial. Fertil Steril 2018;110(6):1129–36. [DOI] [PubMed] [Google Scholar] - 5.Secura GM, Madden T, McNicholas C, et al. Provision of no-cost, long-acting contraception and teenage pregnancy. N Engl J Med 2014;371(14):1316–23. [DOI] [PMC free article] [PubMed] [Google Scholar] - 6.Tyson N, Lopez M, Merchant M, Postlethwaite D. Subdermal contraceptive implant insertion trends and retention in adolescents. J Pediatr Adolesc Gynecol. 2020:S1083–3188(20)30433-2. doi: 10.1016/j.jpag.2020.12.019. [DOI] [PubMed] [Google Scholar] - 7.Romano ME, Braun-Courville DK. Assessing weight status in adolescent and young adult users of the etonogestrel contraceptive implant. J Pediatr Adolesc Gynecol 2019;32(4):409–14. [DOI] [PMC free article] [PubMed] [Google Scholar] - 8.Steiner RJ, Liddon N, Swartzendruber AL, Rasberry CN, Sales JM. Long-acting reversible contraception and condom use among female US high school students: implications for sexually transmitted infection prevention. JAMA Pediatr 2016;170(5):428–34. [DOI] [PMC free article] [PubMed] [Google Scholar]