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Intrauterine Devices and Contraceptive Implants: Overview of Options and Updates on Method Use

  • Family Planning (A Burke, Section Editor)
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Abstract

Purpose of Review

Intrauterine devices (IUDs) and contraceptive implants offer safe and highly effective long-acting reversible contraception (LARC) without requiring routine effort from users. A majority of women who choose these methods report high satisfaction; 12-month continuation rates typically exceed 80%. We summarize some of the latest research and recommendations for use of currently available LARC methods to promote high-quality service delivery.

Recent Findings

New hormonal LARC methods are available, and research suggests that the duration of contraceptive protection for some existing methods extends beyond current manufacturer instructions. Updated evidence-based guidelines recommend that most women, including women with various medical conditions, can safely use IUDs and/or contraceptive implants. Initiation can be timed to whenever pregnancy is reasonably excluded, and few, if any, examinations or tests are required prior to insertion. We highlight some considerations for the use of these methods by adolescents and by women who are postpartum or breastfeeding and immediately following abortion.

Summary

LARC methods offer many attractive features to women seeking contraception, and there are a growing number of options available for women to consider. Evidence-based recommendations should guide determinations of medical eligibility. Implementing best practices for safe and effective provision of LARC and optimizing opportunities for contraceptive initiation enables providers to better respond to women’s needs. Access to contraception and family planning, including LARC, is critical to the health and well-being of women, families, and communities worldwide.

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Authors and Affiliations

  1. Division of Family Planning, Department of Obstetrics and Gynecology and Women’s Health, Albert Einstein College of Medicine–Montefiore Medical Center, 1695 Eastchester Rd, 5th floor, Bronx, NY, 10461, USA

    M. K. Findley & E. E. Levi

  2. Gynuity Health Projects, 15 East 26th Street, Suite 801, New York, NY, 10009, USA

    M. V. Dragoman

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  1. M. K. Findley
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Correspondence to M. K. Findley.

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M.K.F. receives grant funding from the Society of Family Planning, grant #SFPRF16-21, but did not receive financial support or assistance of any kind in the production of this manuscript.

E.E.L. receives grant funding from the Society of Family Planning, grant #SFPRF10-9, but did not receive financial support or assistance of any kind in the production of this manuscript.

M.V.D. has no conflicts of interest to report.

Human and Animal Rights and Informed Consent

All studies performed by Erika Levi, MD, MPH, involving animal and/or human subjects were performed after the approval of the appropriate institutional review boards. When required, written informed consent was obtained from all participants.

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This article is part of the Topical Collection on Family Planning

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Findley, M.K., Levi, E.E. & Dragoman, M.V. Intrauterine Devices and Contraceptive Implants: Overview of Options and Updates on Method Use. Curr Obstet Gynecol Rep 6, 85–93 (2017). https://doi.org/10.1007/s13669-017-0200-8

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