More than 90% of women who opt for
long-term reversible forms of birth control keep using them for at least six
months, a new study found. Those birth control methods include intrauterine
devices (IUDs) and contraceptive implants.
The findings mean most women did not have
side effects, such as cramping or bleeding, that were serious enough for them
to stop using their birth control."There is the perception among
healthcare providers that women discontinue these methods rapidly," senior
author Dr Tessa Madden said. She is an assistant professor of obstetrics and gynaecology
at the Washington University School of Medicine in St Louis.
IUDs are placed inside the uterus and
prevent pregnancy for up to five or 10 years, depending on the brand. The
contraceptive implant is inserted under the skin of a woman's arm and works for
three years. Both methods are 99% effective at preventing pregnancy – better
than the Pill, the vaginal ring and condoms. But they are used by less than one
in ten US women.
is partly because some doctors may assume women will not be happy with these
methods, the researchers said. "We hope that this study helps reassure
providers that the discontinuation rate is not a big concern," Madden said.
Her team's study included about 6000 women between the ages of 14 and 45.
Women could choose to start using the
levonorgestrel-releasing IUD (marketed as Mirena), the copper IUD (ParaGard) or
the contraceptive implant (Implanon).The researchers counselled women about
what to expect with their chosen birth control method. Then they kept track of
if, when and why women stopped using their birth control through phone calls.
About 8% of women using levonorgestrel IUDs or
implants and 8% of copper IUD users chose to have their device removed during the
first six months.
Younger women continued using these methods
just as often as older women did, according to findings published in the
journal Obstetrics and Gynaecology.
Younger women benefit most
"We showed in this analysis that fewer
than 10% of women discontinue before six months, and that the same is true for
teens," Gina Secura said. An epidemiologist at Washington University in St
Louis, she also worked on the study. That's important because younger women may
stand to benefit most from IUDs or contraceptive implants, Madden told Reuters
These women tend to have more pregnancies than
older women while using other types of birth control, such as the Pill or the
vaginal ring. "Many providers and clinic staff incorrectly believe that
young women will quickly discontinue these (long-acting) methods because of
side effects," Secura told Reuters Health. "Because of this
misconception, providers and clinics are reluctant to offer long-acting
reversible contraceptive methods to many young women.
"This study is one of several that
open the door to making implants and IUDs go-to birth control methods for all
women who want them, the researchers said. "This is a paradigm shift in
family planning," Madden said. She cited recommendations from the American
Congress of Obstetricians and Gynaecologists last year to offer implants and
IUDs as first-line birth control methods to all. "Studies like this will
encourage providers to use these methods more," Madden said, "and to
not create additional barriers for women to get the most effective