the Contraceptive Effect of First-Time Use of Etonogestrel

First-time use of Eutirox?

Doctor, I underwent a medical abortion on November 18, and my first menstrual period after the abortion started on December 23.
I returned for a follow-up on December 28 and began taking the first pill of Ella (ulipristal acetate) at 10 PM that night.
I have been consistent with my dosing since then.
My previous cycle was approximately 35 days.
Will I have contraceptive protection by December 31, the fourth day of taking the pill?

y jie, 20~29 year old female. Ask Date: 2015/12/30

Dr. Lin Wenbin reply Obstetrics and Gynecology

Contraceptive pills take more than 7 days to become effective, and the effectiveness is lower during the first month.

Reply Date: 2015/12/30

More Info

When considering the contraceptive effect of Etonogestrel, particularly after a recent medical abortion, it is important to understand how hormonal contraceptives work and the timing of their effectiveness. Etonogestrel is a progestin used in various forms of hormonal contraception, including the implant and some combination pills.
In your case, you began taking Etonogestrel (often marketed as "Nexplanon" or similar brands) on December 28, following your first menstrual period after the abortion on December 23. Generally, hormonal contraceptives like Etonogestrel can take some time to reach their full contraceptive effect, especially if they are initiated outside of the first five days of the menstrual cycle.
According to guidelines, if you start taking Etonogestrel during the first five days of your menstrual cycle, it is effective immediately. However, since you started taking it on the fourth day of your menstrual cycle, it is likely that you may not have full contraceptive protection until you have taken the medication consistently for at least seven days. Therefore, by December 31, which is the fourth day of taking the medication, you may not yet have achieved full contraceptive effectiveness.

It is crucial to consider that after a medical abortion, your menstrual cycle may take some time to regulate, and ovulation can occur sooner than expected. This means that while you are taking the contraceptive, there is still a risk of ovulation occurring before the medication has fully taken effect.
To ensure maximum protection, it is advisable to use a backup method of contraception, such as condoms, for at least the first seven days of taking Etonogestrel. This will help prevent unintended pregnancy during the time it takes for the contraceptive to become fully effective.

Additionally, it's important to maintain consistent use of the contraceptive as prescribed. If you have any concerns about the timing or effectiveness of your contraceptive method, or if you experience any unusual symptoms, it is always best to consult with your healthcare provider for personalized advice and guidance.

In summary, while Etonogestrel is a highly effective contraceptive method, its effectiveness may not be immediate if started later in the menstrual cycle. Given your timeline, it is prudent to use additional contraceptive methods until you have been on Etonogestrel for at least seven days to ensure you are adequately protected against pregnancy.

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