Etonogestrel

Etonogestrel is a third-generation synthetic progestin (a man-made version of progesterone, a hormone found naturally in our bodies). Etonogestrel is used in the hormonal Implant, which is inserted under the skin, and the Vaginal Ring, which is a relatively new form of contraception. 

Researchers have been exploring the use of Etonogestrel as a form of male contraception^1, and a hormonal coil containing Etonogestrel was trialled in 2015, but was unsuccessful². 

How does it work? 

Etonogestrel works in three ways: it prevents ovulation, changes your cervical fluid to stop sperm from entering your uterus, and changes the lining of your uterus so that a fertilised egg can’t implant³. 

What is it in?

Implant

• Nexplanon

Vaginal ring

• Nuvaring

Is it androgenic?

No.

What are the side effects?

The side effects of Etonogestrel are reported separately for the hormonal implant and the vaginal ring. 

Common side effects affecting people using the hormonal implant¹ are:

• Abdominal pain
• Alopecia
• Anxiety
• Increased appetite
• Breast abnormalities
• Depressed mood
• Dizziness
• Emotional changes
• Fatigue
• Flatulence
• Headaches
• Hot flushes
• Increased risk of infection
• Influenza-like illness
• Decreased libido
• Irregularities in the menstrual cycle
• Nausea
• Ovarian cysts
• Pain
• Skin reactions
• Weight changes

Common side effects affecting people using the Vaginal Ring (reported by the manufacturer*) are:

• Tissue irritation of the vagina or cervix
• Headache (including migraine)
• Mood changes (including depression, especially if you have had depression in the past)
• Nausea and vomiting
• Vaginal discharge
• Weight gain
• Vaginal discomfort
• Breast pain, discomfort, or tenderness
• Painful menstrual bleeds
• Abdominal pain
• Acne
• Lowered libido

*The NuvaRing has historically not been available on prescription in some local health authorities, and the NICE British National Formulary (a collection of guidance for the prescription of medicines) does not collect information on side effects of the vaginal ring. 

References

1. Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press <https://bnf.nice.org.uk/drug/etonogestrel.html> [Accessed on 13 August 2020]
2. Adis Insight. Drug profile: Etonogestrel-releasing intrauterine system – Merck & Co. 7 October 2015. Available from <https://adisinsight.springer.com/drugs/800032917> [Accessed on 13 August 2020]
3. Merck. What is Nexplanon?. Available from <https://www.nexplanon.com/what-is-nexplanon/>  [Accessed on 13 August 2020]
4. Merck. Possible risks and side effects of NuvaRing. Available from <https://www.nuvaring.com/risks-side-effects/>  [Accessed on 13 August 2020]