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Review
. 2011 May 28;71(8):969-80.
doi: 10.2165/11591290-000000000-00000.

Efficacy and safety of long-acting reversible contraception

Amy Stoddard  1 , Colleen McNicholas, Jeffrey F Peipert
Affiliations
Review

Efficacy and safety of long-acting reversible contraception

Amy Stoddard et al. Drugs. .

Abstract

Long-acting reversible contraception (LARC) includes intrauterine devices (IUDs) and the subdermal implant. These methods are the most effective reversible methods of contraception, and have the additional advantages of being long-lasting, convenient, well liked by users and cost effective. Compared with other user-dependent methods that increase the risk of noncompliance-related method failure, LARC methods can bring 'typical use' failure rates more in line with 'perfect use' failure rates. LARC methods are 'forgettable'; they are not dependent on compliance with a pill-taking regimen, remembering to change a patch or ring, or coming back to the clinician for an injection. LARC method failure rates rival that of tubal sterilization at <1% for IUDs and the subdermal implant. For these reasons, we believe that IUDs and implants should be offered as first-line contraception for most women. This article provides a review of the LARC methods that are currently available in the US, including their effectiveness, advantages, disadvantages and contraindications. Additionally, we dispel myths and misconceptions regarding IUDs, and address the barriers to LARC use.

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Figures

Fig. 1
Fig. 1
First-year failure rates with typical use. DMPA = depot medroxyprogesterone acetate; IUD = intrauterine device; LNG = levonorgestrel.[1]
Fig. 2
Fig. 2
Comparing typical effectiveness of contraceptive methods. IUD = intrauterine device. Reproduced with permission from the WHO.[2]
Fig. 3
Fig. 3
Worldwide use of intrauterine contraception.[18]
Fig. 4
Fig. 4
Contraceptive use and non-use in the US. IUD = intrauterine device.[19]
See this image and copyright information in PMC

References

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    1. Wenzl R, van Beek A, Schnabel P, et al. Pharmacokinetics of etonogestrel released from the contraceptive implant Implanon. Contraception. 1998;58(5):283–8. - PubMed

Publication types