Abstract
Objectives
Long-acting reversible contraceptives (LARCs) include the copper-releasing intrauterine
device (IUD), the levonorgestrel-releasing intrauterine system (LNG-IUS) and implants.
Despite the high contraceptive efficacy of LARCs, their prevalence of use remains
low in many countries. The objective of this study was to assess the main reasons
for switching from contraceptive methods requiring daily or monthly compliance to
LARC methods within a Brazilian cohort.
Study Design
Women of 18–50 years of age using different contraceptives and wishing to switch to
a LARC method answered a questionnaire regarding their motivations for switching from
their current contraceptive. Continuation rates were evaluated 1 year after method
initiation. Sample size was calculated at 1040 women. Clinical performance was evaluated
by life table analysis. The cutoff date for analysis was May 23, 2013.
Results
Overall, 1167 women were interviewed; however, after 1 year of use, the medical records
of only 1154 women were available for review. The main personal reason for switching,
as reported by the women, was “fear of becoming pregnant” while the main medical reasons
were nausea and vomiting and unscheduled bleeding. No pregnancies occurred during
LARC use, and the main reasons for discontinuation were expulsion (in the case of
the IUD and LNG-IUS) and a decision to undergo surgical sterilization (in the case
of the etonogestrel-releasing implant). Continuation rate was ~95.0/100 women/year for the three methods.
Conclusions
Most women chose a LARC method for its safety and for practical reasons, and after
1 year of use, most women continued with the method.
Keywords
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Article info
Publication history
Published online: September 30, 2013
Accepted:
September 19,
2013
Received in revised form:
September 14,
2013
Received:
July 8,
2013
Footnotes
☆Conflicts of Interest: None declared.
☆☆Funding: This study received partial financial support from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), grant # 2012/01380-9 and from the National Research Council (CNPq), grant #573747/2008-3.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
