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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="Drugs and Lactation Database (LactMed®) [Internet]" /><meta name="citation_title" content="Segesterone Acetate" /><meta name="citation_publisher" content="National Institute of Child Health and Human Development" /><meta name="citation_date" content="2024/08/15" /><meta name="citation_pmid" content="30371999" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK532495/" /><meta name="citation_keywords" content="Segesterone Acetate" /><meta name="citation_keywords" content="Annovera" /><meta name="citation_keywords" content="Nestoron" /><meta name="citation_keywords" content="Nestorone" /><meta name="citation_keywords" content="Elcometrine" /><meta name="citation_keywords" content="ST-1435" /><meta name="citation_keywords" content="ST 1435" /><meta name="citation_keywords" content="17-Hydroxy-16-methylene-19-norpregn-4-ene-3,20-dione acetate" /><meta name="citation_keywords" content="UNII-9AMX4Q13CC" /><meta name="citation_keywords" content="9AMX4Q13CC" /><meta name="citation_keywords" content="16-Methylene-17-alpha-acetoxy-19-nor-4-pregnene-3,20-dione" /><meta name="citation_keywords" content="19-Norpregn-4-ene-3,20-dione, 17-(acetyloxy)-16-methylene-" /><meta name="citation_keywords" content="C23H30O4" /><meta name="citation_keywords" content="16-methylene-17alpha-acetoxy-19-nor-4-pregnen-3,20-dione" /><meta name="citation_keywords" content="19-Norpregn-4-ene-3,20-dione, 17-hydroxy-16-methylene-, acetate" /><meta name="citation_keywords" content="(8R,9S,10R,13S,14S,17R)-17-acetyl-13-methyl-16-methylene-3-oxo-2,3,6,7,8,9,10,11,12,13,14,15,16,17-tetradecahydro-1H-cyclopenta[a]phenanthren-17-yl acetate" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Segesterone Acetate" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Institute of Child Health and Human Development" /><meta name="DC.Date" content="2024/08/15" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK532495/" /><meta name="description" content="Based on the available evidence, expert opinion in the United States holds that postpartum women who are breastfeeding should not use combined hormonal contraceptives during the first 3 weeks after delivery because of concerns about increased risk for venous thromboembolism and generally should not use combined hormonal contraceptives during the fourth week postpartum because of concerns about potential effects on breastfeeding performance. Postpartum breastfeeding women with other risk factors for venous thromboembolism generally should not use combined hormonal contraceptives until 6 weeks after delivery.[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] A decrease in milk supply can happen over the first few days of estrogen exposure.[3]" /><meta name="og:title" content="Segesterone Acetate" /><meta name="og:type" content="book" /><meta name="og:description" content="Based on the available evidence, expert opinion in the United States holds that postpartum women who are breastfeeding should not use combined hormonal contraceptives during the first 3 weeks after delivery because of concerns about increased risk for venous thromboembolism and generally should not use combined hormonal contraceptives during the fourth week postpartum because of concerns about potential effects on breastfeeding performance. Postpartum breastfeeding women with other risk factors for venous thromboembolism generally should not use combined hormonal contraceptives until 6 weeks after delivery.[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] A decrease in milk supply can happen over the first few days of estrogen exposure.[3]" /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK532495/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-lactmed-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/lactmed/LM1419/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK532495/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} </style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script>
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. </p></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK532495_"><span class="title" itemprop="name">Segesterone Acetate</span></h1><p class="small">Last Revision: <span itemprop="dateModified">August 15, 2024</span>.</p><p><em>Estimated reading time: 2 minutes</em></p></div><div class="body-content whole_rhythm" itemprop="text"><p>CASRN: 7759-35-5</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/388823169" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=388823169" alt="image 388823169 in the ncbi pubchem database" /></a><div id="LM1419.Drug_Levels_and_Effects"><h2 id="_LM1419_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM1419.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Based on the available evidence, expert opinion in the United States holds that postpartum women who are breastfeeding should not use combined hormonal contraceptives during the first 3 weeks after delivery because of concerns about increased risk for venous thromboembolism and generally should not use combined hormonal contraceptives during the fourth week postpartum because of concerns about potential effects on breastfeeding performance. Postpartum breastfeeding women with other risk factors for venous thromboembolism generally should not use combined hormonal contraceptives until 6 weeks after delivery.[<a class="bk_pop" href="#LM1419.REF.1">1</a>] 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.[<a class="bk_pop" href="#LM1419.REF.2">2</a>] A decrease in milk supply can happen over the first few days of estrogen exposure.[<a class="bk_pop" href="#LM1419.REF.3">3</a>]</p></div><div id="LM1419.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> Six postpartum women who were breastfeeding their infants were given subdermal implants containing 20 mg of segesterone acetate. Paired milk and plasma samples were obtained at about 2 weeks after insertion and at 10-day intervals for up to 2 additional times. Among 13 milk samples, the mean segesterone concentration was 37.5 ng/L (range 7 to 73 ng/L).[<a class="bk_pop" href="#LM1419.REF.4">4</a>]</p><p>Sixty-six postpartum women who were fully breastfeeding their infants were given subdermal implants containing 50 mg of segesterone acetate. A breastmilk sample was obtained at 75 days post-insertion from 24 of the women. The average milk level was 138 ng/L (range 73 to 237 ng/L).[<a class="bk_pop" href="#LM1419.REF.5">5</a>]</p><p>One hundred postpartum women who were fully breastfeeding their infants were given subdermal implants containing 80 mg of segesterone acetate at 55 to 60 days postpartum. The implants released about 100 mcg of segesterone acetate daily. Breastmilk samples were obtained from 14 of the women once weekly for the first month after implant insertion, then every 2 weeks until weaning. Milk segesterone levels ranged from 20 to 50 ng/L. The authors estimated that the dose transferred to the infant, assuming a daily intake of 800 mL of milk, was about 50 ng daily in the first month after insertion, decreasing to around 20 ng daily thereafter.[<a class="bk_pop" href="#LM1419.REF.6">6</a>]</p><p><i>Infant Levels.</i> Sixty-six postpartum women who were fully breastfeeding their infants were given subdermal implants containing 50 mg of segesterone acetate. An infant blood sample was obtained at 75 days post-insertion from 25 of the infants. The average infant serum level was 7 ng/L (range <5 to 20 ng/L).[<a class="bk_pop" href="#LM1419.REF.5">5</a>]</p></div><div id="LM1419.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>Relevant published information on segesterone acetate and ethinyl estradiol 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.[<a class="bk_pop" href="#LM1419.REF.5">5</a>,<a class="bk_pop" href="#LM1419.REF.6">6</a>]</p></div><div id="LM1419.Effects_on_Lactation_and_Breastmi"><h3>Effects on Lactation and Breastmilk</h3><p>Relevant published information was not found as of the revision date.</p></div><div id="LM1419.Alternate_Drugs_to_Consider"><h3>Alternate Drugs to Consider</h3><p><a href="/books/n/lactmed/LM622/">Etonogestrel</a>, <a href="/books/n/lactmed/LM1089/">Intrauterine Copper Contraceptive</a>, <a href="/books/n/lactmed/LM421/">Oral Levonorgestrel</a>, <a href="/books/n/lactmed/LM1335/">Intrauterine Levonorgestrel</a>, <a href="/books/n/lactmed/LM1336/">Levonorgestrel Implant</a>, <a href="/books/n/lactmed/LM415/">Medroxyprogesterone Acetate</a>, <a href="/books/n/lactmed/LM419/">Norethindrone</a>, <a href="/books/n/lactmed/LM470/">Progesterone</a></p></div><div id="LM1419.References"><h3>References</h3><dl class="temp-labeled-list"><dt>1.</dt><dd><div class="bk_ref" id="LM1419.REF.1">Nguyen
|
||
AT, Curtis
|
||
KM, Tepper
|
||
NK, et al.
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||
U.S. Medical Eligibility Criteria for Contraceptive Use, 2024.
|
||
MMWR Recomm Rep
|
||
2024;73:1-126.
|
||
[<a href="/pmc/articles/PMC11315372/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC11315372</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/39106314" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 39106314</span></a>]</div></dd><dt>2.</dt><dd><div class="bk_ref" id="LM1419.REF.2">World Health Organization. Medical Eligibility Criteria For Contraceptive Use: Fifth Ed. 2015. <a href="https://www.who.int/publications/i/item/9789241549158" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>.who.int/publications<wbr style="display:inline-block"></wbr>/i/item/9789241549158</a> [<a href="https://pubmed.ncbi.nlm.nih.gov/26447268" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26447268</span></a>]</div></dd><dt>3.</dt><dd><div class="bk_ref" id="LM1419.REF.3">Moses-Kolko
|
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EL, Berga
|
||
SL, Kalro
|
||
B, et al.
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||
Transdermal estradiol for postpartum depression: A promising treatment option.
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||
Clin Obstet Gynecol
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||
2009;52:516-29.
|
||
[<a href="/pmc/articles/PMC2782667/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2782667</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19661765" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19661765</span></a>]</div></dd><dt>4.</dt><dd><div class="bk_ref" id="LM1419.REF.4">Lähteenmäki
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PL, Díaz
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||
S, Miranda
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||
P, et al.
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||
Milk and plasma concentrations of the progestin ST-1435 in women treated parenterally with ST-1435.
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||
Contraception
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||
1990;42:555-62.
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||
[<a href="https://pubmed.ncbi.nlm.nih.gov/2272183" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2272183</span></a>]</div></dd><dt>5.</dt><dd><div class="bk_ref" id="LM1419.REF.5">Coutinho
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||
EM, Athayde
|
||
C, Dantas
|
||
C, et al.
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||
Use of a single implant of elcometrine (ST-1435), a nonorally active progestin, as a long acting contraceptive for postpartum nursing women.
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||
Contraception
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||
1999;59:115-22.
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||
[<a href="https://pubmed.ncbi.nlm.nih.gov/10361626" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10361626</span></a>]</div></dd><dt>6.</dt><dd><div class="bk_ref" id="LM1419.REF.6">Massai
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||
MR, Díaz
|
||
S, Quinteros
|
||
E, et al.
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||
Contraceptive efficacy and clinical performance of Nestorone implants in postpartum women.
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||
Contraception
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||
2001;64:369-76.
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||
[<a href="https://pubmed.ncbi.nlm.nih.gov/11834236" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11834236</span></a>]</div></dd></dl></div></div><div id="LM1419.Substance_Identification"><h2 id="_LM1419_Substance_Identification_">Substance Identification</h2><div id="LM1419.Substance_Name"><h3>Substance Name</h3></div><div id="LM1419.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>7759-35-5</p></div><div id="LM1419.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Milk, Human</p><p>Contraceptive Agents, Female</p></div></div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></div><div id="bk_toc_contnr"></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a><p class="small"><b>Attribution Statement:</b> LactMed is a registered trademark of the U.S. Department of Health and Human Services.</p></div><div class="small"><span class="label">Bookshelf ID: NBK532495</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/30371999" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">30371999</a></span></div><div style="margin-top:2em" class="bk_noprnt"><a class="bk_cntns" href="/books/n/lactmed/">Contents</a><div class="pagination bk_noprnt"><a class="active page_link prev" href="/books/n/lactmed/LM1165/" title="Previous page in this title">< Prev</a><a class="active page_link next" href="/books/n/lactmed/LM847/" title="Next page in this title">Next ></a></div></div></div></div>
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