Question

I am a breastfeeding mother and i want to know if it is safe to use Segesterone? Is Segesterone safe for nursing mother and child? Does Segesterone extracts into breast milk? Does Segesterone has any long term or short term side effects on infants? Can Segesterone influence milk supply or can Segesterone decrease milk supply in lactating mothers?

Answer by DrLact: About Segesterone usage in lactation

Segesterone acetate is available in the United States in a combination contraceptive vaginal ring (Annovera) that releases segesterone acetate and ethinyl estradiol. No information is available on the use of this product during breastfeeding; however, segesterone is poorly bioavailable orally, so systemic exposure to segesterone in breastfed infants will be minimal. Based on the available evidence, expert opinion in the United States holds that because of the clotting risk, combination contraceptive products should not be used before 3 weeks postpartum. Between 3 weeks and 6 months postpartum, the advantages of using the method generally outweigh the theoretical or proven risks, although the evidence of lack of effect on lactation is poor and does not include preterm or ill infants. After 6 months postpartum, combination contraceptives, including oral tablets, the transdermal patch and vaginal ring, can be used, but progestin-only methods are preferred if breastfeeding will be continued.[1] World Health Organization guidelines are more restrictive, stating that combined oral contraceptives should not be used in nursing mothers before 42 days postpartum and the disadvantages of using the method generally outweigh the advantages between 6 weeks and 6 months postpartum.[2] The manufacturer of Annovera recommends that another form of contraception should be used until breastfeeding is discontinued.

Segesterone Side Effects in Breastfeeding

Relevant published information on segesterone acetate and ethinylestradiol vaginal insert was not found as of the revision date. Studies on the use of segesterone acetate implants have found no adverse effects on growth and development.[4][5]
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