Efficacy and Safety of Long-Acting Reversible Contraception

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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Table I

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Acknowledgements

This work was supported in part by a Midcareer Investigator Award in Women’s Health Research (K24 HD01298) and by a Clinical and Translational Science Award (UL1RR024992) from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH.[57,58] The authors have no conflicts of interest that are directly relevant to the content of this review.

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Correspondence to Dr Jeffrey F. Peipert.

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Stoddard, A., McNicholas, C. & Peipert, J.F. Efficacy and Safety of Long-Acting Reversible Contraception. Drugs 71, 969–980 (2011). https://doi.org/10.2165/11591290-000000000-00000

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Keywords

  • Pelvic Inflammatory Disease
  • Emergency Contraception
  • Insertion Tube
  • Abnormal Uterine Bleeding
  • Male Condom