August 17, 2015 — Women who use intrauterine devices for long-acting reversible contraception are more likely to continue using them for several years than women who choose shorter-acting methods, according to a study published this month in the American Journal of Obstetrics and Gynecology, Reuters reports.
Researchers analyzed information from the Contraceptive CHOICE Project. According to Reuters, the CHOICE Project included women who were ages 14 to 45, sexually active with a male partner and wanted to start using a new form of reversible contraception.
Study participants were counseled on different reversible contraception methods. The methods included LARCs, such as hormonal intrauterine devices, copper IUDs and implants. Non-LARC options included hormonal injections, daily birth control pills, contraceptive patches or vaginal rings.
After the participants learned about the contraceptive methods, they were tested for sexually transmitted infections and received the contraceptive method of their choice at no charge.
The researchers followed up with 4,708 women in the St. Louis area every six months for three years through telephone surveys. Of this group, 3,203 had chosen LARCs. The study excluded women who chose to stop using birth control because they wanted to get pregnant.
The researchers found that after three years, "nearly 70 percent of women who had chosen the hormonal or copper IUD were still using it, and 56 percent of women with a subdermal implant still had it." By contrast, about 30% of women who had chosen non-LARCs still were using them.
Justin Diedrich of Washington University, who was the study's lead author, said, "At 24 months ... about 75 percent of women using LARCs continued their baseline contraceptive" and "[a]t 36 months two-thirds continued" to do so.
According to the study, the women who chose the LARCs were more likely to be older, have public insurance and have a history of unintended pregnancy.
Diedrich said, "These results are very reassuring -- they show ... that women using the most effective methods of birth control continue at high rates."
Megan Kavanaugh, a senior research scientist at the Guttmacher Institute who was not part of the study, said, "This is creating more evidence to support the idea that women who are using IUDs and implants seem to be highly satisfied."
However, Diedrich noted that some women could face difficulties covering the cost of a LARC. For example, he noted that an IUD can cost more than $1,000, while a one-month pack of birth control pills costs between $10 and $30. He also said some women who lack insurance cannot afford LARCs, and some insurers that are affiliated with religious organizations do not cover birth control.
Nonetheless, he said LARCs ultimately are the most cost-effective contraceptive method because while "[t]here may be a higher upfront cost for LARC methods ... they work much better, and people use them longer" (Doyle, Reuters, 8/14).