Adolescents, Young Women Not More Likely to Discontinue Long-Acting Birth Control

Patients with long-acting reversible contraception seem happy with their use, as evidenced by low discontinuation rates at 6 months, according to an analysis of data from the Contraceptive CHOICE Project.

Started as a research project at Washington University School of Medicine in St. Louis, Missouri, to remove financial barriers to contraception, the Contraceptive CHOICE Project promotes effective methods of birth control and aims to reduce unintended pregnancy in the St. Louis area. More than 9000 women aged 14 to 45 years participated in the study, and 75% of them chose a long-acting reversible contraceptive (LARC) method (intrautererine device [IUD] or implant).

Previous findings of the Contraceptive CHOICE Project showed that 86% of patients in the study who chose long-acting methods of contraception were still using their method at 1 year, compared with 55% of women who chose non-long-acting methods. However, the researchers wanted to better understand why those who chose to discontinue use of long-acting methods did so.

Of the original participants, 6167 women were eligible for this discontinuation analysis; of these, follow-up data were available for 5928 participants. At 6 months, 433 women (7%) had discontinued use of LARC. Specific discontinuation rates were 7.3% for levonorgestrel intrauterine system, 8.0% for copper IUD, and 6.9% for etonogestrel implant, the researchers reported.

Adjusted data showed that unmarried women were slightly more likely than married women to discontinue use of a LARC. Younger age (14 to 19 years) was not associated with early discontinuation, and neither were any other baseline characteristics, including race, low socioeconomic status, and history of sexually transmitted infection.

The most commonly reported reasons for discontinuation, according to the researchers, was cramping (IUD users) and irregular or frequent bleeding (implant users).

The overall rate of discontinuation for LARC methods is low, and adolescents and young women seem to respond well to this type of contraception, the study authors reported.

“Intrauterine devices and the implant should be considered as first-line contraceptive options among all women to reduce unintended pregnancy,” the study authors concluded.

Pertinent Points:
- The overall rate of discontinuation at 6 months for long-acting reversible contraceptive methods is 7%.
- Adolescents and younger women were no more likely to discontinue use than older women.

References:

References

Grunloh DS, Casner T, Secura GM, et al. Characteristics associated with discontinuation of long-acting reversible contraception within the first 6 months of use.

Obstet Gynecol.

2013 Nov 6. [Epub ahead of print]

The Contraceptive CHOICE Project Web site. Available

here

. Accessed November 20, 2013.