Who should avoid using the Etonogestrel (Nexplanon) implant for contraception?

• A. Women with coronary artery disease
• B. Women who have migraine headaches
• C. Women who are breastfeeding
• D. Women with a personal history of breast cancer

Answer: (D)

The Etonogestrel implant, known as Nexplanon, is a form of long-acting reversible contraception that releases hormones to prevent ovulation. However, it is contraindicated in individuals with a personal history of breast cancer. This is primarily due to the hormone component of the implant. Some studies suggest that hormones can stimulate certain types of breast cancer, and thus, the use of hormonal contraceptives in women with a history of breast cancer may potentially lead to cancer recurrence or progression.

For women with coronary artery disease, while caution is advised, they may still be considered for the implant if they are not at a high risk. Women with migraine headaches, depending on the type and severity, may also use a hormonal implant, although the presence of migraine with aura might warrant additional consideration. Breastfeeding women can typically use Nexplanon without significant concerns, as it is considered safe and does not negatively impact breast milk production.

Thus, the recommendation for avoiding Etonogestrel in those with a personal history of breast cancer is grounded in safety and the potential risks associated with hormone exposure in this sensitive population.