Contraceptive Pearl: Progestin Implant Update

In 2006 the FDA approved the progestin implant. At the time, the device was approved for 3-year duration. Studies since then provide evidence that the progestin implant is effective for up to 5 years, although the labeling remains at 3 years. The progestin implant is a soft, flexible polymer about the size of a match stick that is inserted subdermally in the upper arm. The implant works by releasing 68 mg of progestin etonogesterel slowly over a 5-year period. After five years, the device should be removed.

Clinicians who haven’t been trained must take a 3-hour course. Those who have completed an in-person training in the past must complete an online update before June 1, 2019. Find information about both types of trainings here.

The implant’s main side effects are spotting and amenorrhea. Many users have unpredictable spotting, and other users have no periods. The implant may also cause mood changes, acne, and skin changes in the upper arm. Anticipatory guidance is important. The implant is 99.9% effective at preventing pregnancy for up to five years. It’s a great choice for people who want long-term, reversible contraception, and who prefer not to get an intrauterine device.



Progestin Implant User Guide

Progestin Implant Fact Sheet

Progestin Only Birth Control Sheet



Ali M, Akin A, Bahamondes L, Brache V, Habib N, Landoulsi S, Hubacher D. WHO study group on subdermal contraceptive implants for women. Hum Reprod. 2016;31(11): 2491-2498.

Prine L, Shah M. Long-Acting Reversible Contraception: Difficult Insertions and Removals. Am Fam Physician. 2018;98(5): 304-309.

Wu JP, Moniz MH, Ursu AN. Long-acting Reversible Contraception – Highly Efficacious, Safe, and Underutilized. JAMA. 2018;320(4):397-398.



The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.

Contraceptive Pearls

This monthly clinical e-newsletter highlights evidence-based best practice for contraceptive care

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