LARC for adolescents. Considerations on the incorporation of the etonogestrel subdermal implant into the Brazilian Unified Health System

Abstract

This article addresses the public debate in Brazil regarding the Ministry of Health's recent incorporation of the etonogestrel subdermal implant into the Unified Health System (SUS) for adolescents aged 14 to 17, through SECTICS/MS Ordinance No. 48 of July 8, 2025, published by the Secretariat of Science, Technology, Innovation, and Strategic Health Inputs, after review by the National Commission for the Incorporation of Technologies into the Unified Health System (CONITEC). It highlights some structural dimensions to be considered in public health policies aimed at adolescence: sexuality education, in its comprehensive and dialogical framework, gender inequalities and discrimination, anti-racist and nonviolent education, the fight against sexual and gender-based violence, and the guarantee of social rights that allow the affirmation of reproductive justice among our adolescents and young women. Health care in family planning needs to go far beyond the strict provision of a long-acting reversible hormonal contraceptive method, whose acceptability and adaptation will require attention to the health of adolescents, periodic clinical monitoring and respect for their decisions regarding the eventual removal of the device, before the three-year period.