Long-Acting Reversible Contraceptives Safe for Most

Despite benefits, most women use other methods due to lack of knowledge and cost concerns

TUESDAY, June 21 (HealthDay News) -- Long-acting reversible contraceptives (LARC) are safe and effective for almost all women of reproductive age, according to an American College of Obstetricians and Gynecologists (ACOG) practice bulletin published in the July issue of Obstetrics & Gynecology.

Eve Espey, M.D., M.P.H., and Rameet H. Singh, M.D., M.P.H., from ACOG in Washington, D.C., and colleagues compiled the latest recommendations on LARC use. The recommendations identify candidates for LARCs and help obstetricians and gynecologists manage LARC-related clinical issues.

The investigators reported that the LARC methods currently available have few contraindications, and that most women are eligible to use them. Intrauterine devices (IUDs) are suitable for women with a previous ectopic pregnancy and for women immediately after abortion or miscarriage. Routine antibiotic prophylaxis is not recommended before IUD insertion. Copper IUD inserted up to five days after unprotected intercourse is the most effective method of postcoital contraception. The copper IUD can be used and remains effective for up to 10 continuous years. The levonorgestrel IUD may be effective for up to seven years. IUD complications are rare and include expulsion, method failure, and perforation. Implants can be safely inserted at any time after childbirth in nonbreast-feeding women, or after four weeks for breast-feeding mothers. All LARC methods are safe for nulliparous women and adolescents. The use of IUDs increased from 1.3 to 5.5 percent from 2002 to 2006-2008. Despite the benefits of LARCs, the majority of women choose other birth control methods, probably due to lack of knowledge about LARCs and cost concerns.

"LARC methods are the best tool we have to fight against unintended pregnancies, which currently account for 49 percent of U.S. pregnancies each year," Espey said in a statement.

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