Can Implanon Cause Hair Loss?
Hair loss is a recognized but uncommon adverse effect of Implanon (etonogestrel implant), occurring infrequently enough that it is not listed among the most common side effects in clinical guidelines or major clinical trials.
Evidence from Clinical Trials
The most comprehensive safety data comes from integrated analyses of Implanon clinical trials:
Hair loss is classified as a "possibly steroid-related" adverse event but is "much less frequently reported" compared to common side effects like headaches, acne, weight changes, and mood alterations 1
In the largest integrated safety analysis of 1,716 Implanon users, hair loss was not among the frequently reported drug-related adverse events, which were dominated by acne (18.5%), breast pain, headache, and weight gain 2
The overall rate of drug-related adverse events was 47% in Implanon users, but hair loss represented only a small fraction of these reports 2
Clinical Context and Mechanism
Progestin-only contraceptives like Implanon can theoretically affect hair growth through hormonal mechanisms:
Progestins with androgenic activity may influence hair follicles, though etonogestrel has relatively low androgenic potency compared to older progestins 1
The low hormonal dose delivered by the single-rod etonogestrel system (68 mg total, released gradually over 3 years) contributes to its favorable safety profile 1, 3
Common Pitfalls in Clinical Practice
When a patient reports hair loss while using Implanon:
Rule out other causes first: thyroid dysfunction, iron deficiency, nutritional deficiencies, stress-related telogen effluvium, and other medications are far more common causes of hair loss than the implant itself 1
Temporal association does not prove causation: many women experience hair changes unrelated to contraception during their reproductive years 1
Counsel about the most common actual side effects before insertion: irregular bleeding patterns (affecting 78% of users), headaches, and acne are the adverse events most likely to affect quality of life and continuation rates 4, 2
Management Approach
If hair loss occurs during Implanon use:
Evaluate for alternative etiologies through appropriate laboratory testing (thyroid function, ferritin, complete blood count) before attributing the symptom to the implant 1
If no other cause is identified and hair loss is distressing to the patient, counsel on alternative contraceptive methods and offer another highly effective option such as the copper IUD (which has no hormonal effects) or a levonorgestrel IUD (which has primarily local rather than systemic hormonal effects) 4
Document that hair loss with Implanon is uncommon and that removal typically allows resolution if the implant is indeed the cause 1