A three-year comparative study of continuation rates, bleeding patterns and satisfaction in Australian women using a subdermal contraceptive implant or progestogen releasing-intrauterine system. (February 2014)

• Record Type: Journal Article
• Authors: Weisberg, Edith; Bateson, Deborah; McGeechan, Kevin; Mohapatra, Lita
• Is Part Of: European journal of contraception & reproductive health care. Volume 19:Number 1(2014:Feb.)
• Page Start: 5
• Page End: 14
• Publication Date: 2014-02
• Subjects: Contraception -- Periodicals; Reproductive health -- Periodicals; Generative organs, Female -- Periodicals; Contraception -- Periodicals; Reproductive Medicine -- Periodicals; 613.9
• DOI: 10.3109/13625187.2013.853034
• Languages: English
• ISSNs: 1362-5187

Abstract

<abstract> <title>Abstract</title> <p> <bold>Background</bold> Long-acting reversible contraceptive methods (LARCs) are safe, highly effective, readily reversible, and require no action on the part of the user following insertion. Early discontinuation may put women at increased risk of unintended pregnancy.</p> <p> <bold>Methods</bold> Following insertion of a progestogen-only subdermal implant or intrauterine system (IUS) at Family Planning NSW, women 18 years and older completed a questionnaire about their choice. At 6 weeks, 6, 12, 24 and 36 months by telephone or online they completed a questionnaire about bleeding patterns, side effects, satisfaction, and reasons for discontinuation.</p> <p> <bold>Results</bold> Two hundred IUS users and 149 implant users were enrolled. The former were generally older, married or in a de-facto relationship, and had children. Forty-seven percent of implant users discontinued within three years compared to 27% of IUS users (<italic>p = </italic>0.002). In the first two years amenorrhoea was more frequent in implant users. Frequent bleeding/spotting was more prevalent in the first year of IUS use but over time was twice as prevalent in implant users. Infrequent bleeding/spotting was more common in IUS users.</p> <p> <bold>Conclusion</bold> Both devices are highly effective and acceptable cost-effective methods. While LARCs should be promoted to women of all ages seeking contraception, early discontinuation due to unacceptable bleeding highlights the need for pre-insertion counselling.</p> </abstract>