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The UK Faculty of Sexual & Reproductive Healthcare (FSRH) has updated its 2014 guideline1 on the progestogen-only implant, reexamining old evidence, reflecting new evidence and highlighting changes in practice. While much remains unchanged, important new information and guidance is provided about the change in recommended etonogestrel implant (ENG-IMP) insertion site, duration of ENG-IMP use and expected bleeding patterns, and the evidence around the highly topical risk of intravascular insertion is set out.
The ENG-IMP is still the only available contraceptive implant in the UK. Evidence suggests that it provides highly effective contraception for 3 years even in users with raised body mass index. Most of the reported pregnancies during ENG-IMP use were conceived before implant insertion or established efficacy, or where efficacy was reduced by enzyme-inducing medication. There have been very few reported pregnancies during established use with no accountable reason for contraceptive failure.
Clarity is provided around the routine use of the ENG-IMP in the fourth year (note this varies from …
Contributors KLG wrote the original draft. SMH helped revise the manuscript.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.