| August 2012 · Vol. 24, No. 8 Editorial
FIRST OF 2 PARTS
Let’s increase our use of IUDs
and improve contraceptive
effectiveness in this country
The unintended pregnancy rate is too high in the United States, and the use of long-acting reversible contraceptives is too low. Expanding the patient population to which we prescribe intrauterine devices could help many women avoid unintended pregnancy.
Robert
L.
Barbieri,
MDEditor in Chief
ROBERT.BARBIERI@QHC.COM
Most studies indicate that the three available long-acting reversible contraceptives (LARCs)—
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copper intrauterine device (IUD)
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levonorgestrel-releasing intrauterine system (LNG-IUS)
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etonogestrel-releasing implant (Nexplanon)
—are the most effective reversible contraceptive methods. The injection of depot medroxyprogesterone acetate (DMPA) is also highly effective. In a large cohort study, by Winner and colleagues, of 7,486 women who were prescribed a reversible contraceptive, the contraceptive failure rate among women using a contraceptive pill, patch, or vaginal ring was 4.55 per 100 woman-years.1 For women using an IUD or etonogestrel implant, the contraceptive failure rate was 0.27 per 100 woman-years, and in women using DMPA, the contraceptive failure rate was 0.22. After adjusting for differences in age and education levels, the investigators found that women using the pill, patch, or vaginal ring were 21.8 times more likely to become pregnant than women using an IUD or etonogestrel implant.
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