A new study has found that shorter-acting methods of birth control, such as the Pill and the contraceptive patch, are much less effective at preventing unintended pregnancies than long-acting birth control methods such as intrauterine devices, or IUDs, and implants.
There are approximately six million pregnancies in the U.S. each year, and about half of them are unplanned. Approximately half of the unintended pregnancies are due to contraceptive failure, especially among younger women who use short-acting birth control methods. These include the Pill, which must be taken daily, and the hormone patch, which women must remember to change on a regular basis.
Jeffrey Piepert, a professor of obstetrics and gynecology at Washington University School of Medicine in St. Louis, Missouri, says experts knew that so-called longer-acting reversible contraceptives, or LARC (LARK) methods, offered better protection against pregnancy than the Pill or the patch.
“What we didn’t expect was the magnitude of the difference. There were 20-fold greater number of contraceptive failures in the Pills, patch and ring group compared to the LARC methods,” said Piepert.
The finding was based on a study by Washington University researchers comparing long-acting contraceptive methods to short-acting ones.
Intrauterine Device (IUD) for Birth Control
An IUD is a small, T-shaped plastic device that is wrapped in copper or contains hormones. The IUD is inserted into your uterus by your doctor. A plastic string tied to the end of the IUD hangs down through the cervix into the vagina. You can check that the IUD is in place by feeling for this string. The string is also used by your doctor to remove the IUD.
Types of IUDs
- Hormonal IUD. The hormonal IUD, such as Mirena, releases levonorgestrel, which is a form of the hormone progestin. The hormonal IUD appears to be slightly more effective at preventing pregnancy than the copper IUD. The hormonal IUD is effective for at least 5 years.
- Copper IUD. The most commonly used IUD is the copper IUD (such as Paragard). Copper wire is wound around the stem of the T-shaped IUD. The copper IUD can stay in place for at least 10 years and is a highly effective form of contraception.
LARC methods of contraception include the intrauterine device, or IUD, and hormone-releasing implants. There are two types of IUDs; one releases tiny amounts of hormone over a period of years that prevents conception and the other contains copper that makes the uterus inhospitable to fertilized embryos. The copper IUD can remain in place for up to ten years. Implants, just beneath the skin, contain hormones that prevent ovulation. Both IUDs and implants must be put in place by a health care professional.
The study involved 7,500 women between the ages of 14 and 45 who were sexually active or wanted to become active, but didn’t want to become pregnant for at least 12 months.
Over the course of the three-year study, 334 women became pregnant, including 156 pregnancies due to contraception failure. Of these, 133 women were using the Pill, patch or vaginal ring, compared to just 21 who had been using IUDs or implants for years.
How do you use an intrauterine device?
Your healthcare provider will perform a pelvic exam, Pap test,and possibly cultures for STD’s prior to inserting the intrauterine device. The intrauterine device is placed through the vagina and cervix, into the uterus by your healthcare provider.
A follow-up visit is scheduled two to three months after the system is inserted. Unless there are problems, or it is time for your annual exam, there is no need to visit the physician until it is removed. IUDs may remain in place from five to ten years, depending on the type.
You are encouraged to check for the string following each menstruation to confirm that the IUD is still in place. Do not pull on the string.
How effective is an intrauterine device?
The intrauterine system possesses a failure rate of less than 1%. This means that fewer than one out of every 100 IUD users will become pregnant during the first year of use. You should take a pregnancy test if you are experiencing any pregnancy symptoms.