June 23, 2011 — Long-acting reversible contraceptives -- including intrauterine devices and hormonal implants -- are the most effective types of contraception and should be encouraged for most women and adolescents seeking birth control, according to new recommendations by the American College of Obstetricians and Gynecologists, HealthDay/USA Today reports.
According to an ACOG practice bulletin in the July issue of Obstetrics & Gynecology, IUDs -- T-shaped devices implanted in the uterus -- have a failure rate of less than 1% and can stay in place for up to 10 years. The risk of pelvic inflammatory disease associated with IUDs is negligible, the bulletin said. Hormonal implants -- small rods placed under the skin surface that emit a progestin-type hormone for three years -- have a failure rate of 0.05%.
The bulletin states, "Encouraging the use of long-acting reversible contraceptive methods for appropriate candidates may help lower U.S. unintended pregnancy rates because gaps in use and discontinuation of shorter acting methods are associated with unintended pregnancy rates in high-risk women."
Adam Jacobs, medical director of the family planning division at Mount Sinai Medical Center, said IUDs are the "most cost-effective form" of birth control available. While only 6% of women using birth control currently use IUDs or hormonal implants, Jacobs said rates are quickly rising as physicians catch on to the practice that is already in use at major teaching hospitals. However, barriers to use, such as unfamiliarity and up-front costs, remain. Insertion of IUDs and hormonal implants can cost between $400 and $750, plus physician fees, though many insurance plans pay part of the expense (Holohan, HealthDay/USA Today, 6/22).