Clinical Edge

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Hormonal and Intrauterine Contraception

Comparing pregnancy failure rates

Contraceptive efficacy or continuation did not differ significantly in head-to-head trials comparing contraceptive use among 1,503 women aged 25 years or younger. Five trials were included in the criteria and the study compared the following contraceptives: combined oral contraceptive (COC) vs. transdermal contraceptive patch, vaginal contraceptive ring, or levonorgestrel intrauterine system 20 µg/day (LNG-IUS 20); LNG-IUS 12 µg/day (LNG-IUS 12) vs. LNG-IUS 16 µg/day (LNG-IUS 16); and LNG-IUS 20 vs. the copper T380A intrauterine device (IUD). Researchers found:

• The COC group had a higher proportion of women who discontinued for “other personal reasons” compared with the group assigned to the LNG-IUS 20.

• Trial comparing LNG-IUS 12 vs. LNG-IUS 16 showed similar efficacy over 1 and 3 years.

• Continuation was at least 75% at 6 to 36 months in 3 trials that examined different LNG-IUS.

Citation: Krashin J, Tang JH, Mody S. Lopez LM. Hormonal and intrauterine methods for contraception for women aged 25 years and younger. Cochrane Database Syst Rev. [Published online ahead of print August 17, 2015]. doi: 10.1002/14651858.CD009805.pub3.