Long-acting contraceptives are better

Long-acting contraceptives are better

Long-acting contraceptives, such as IUDs and implants, are up to 20 times more effective than oral contraceptives and other short-acting contraceptive methods, according to a new study. In a large, prospective cohort study, women participants were provided with the reversible contraception of their choice at no cost for 3 years. The endpoint was failure of long-acting reversible contraception (IUDs and implants) compared with commonly prescribed contraceptive methods, including oral contraceptive pills, transdermal patches, contraceptive vaginal rings, and depot medroxyprogesterone acetate injection (DMPA). In the nearly 7500 women participants, there were 334 unintended pregnancies. The failure rate among participants who used pills, patch, or ring was 4.55 per 100 participants years as compared with 0.27 among participants using long-acting reversible contraception (HR after adjustment for age, educational level, and history with respect to unintended pregnancy 21.8; 95% CI, 13.7 to 34.9). The rate for DMPA was also low at 0.22. Younger women (< 21 years) who used a short-acting contraceptive had a pregnancy rate almost twice as high as older participants. The pregnancy rate among women who used DMPA, an IUD, or implant were similarly low regardless of age. The authors conclude that the effectiveness of long-acting reversible contraception is superior to that of contraceptive pills, patch, or ring and is not altered in adolescents or young woman (N Engl J Med 2012;366:1998-2007). This study not only points out the reliability of long-acting contraceptives, but also the surprisingly high failure rate of short-acting contaceptives, especially in young women.