Long-Acting Reversible Contraception

Abstract

Unwanted pregnancy is a major public health problem both in developed and developing countries. Although the reduction in the rates of these pregnancies requires multifactorial approaches, increasing access to long-acting contraceptive methods can contribute significantly to change this scenario. In Brazil, gynecologists and obstetricians play a key role in contraceptive counseling, being decisive in the choice of long-acting reversible methods, characterized by intrauterine devices (IUDs) and the contraceptive implant. The vast scope due to the reduced number of situations to indicate long-acting methods should be emphasized in routine contraceptive counseling. On the other hand, gynecologists and obstetricians should adapt the techniques of insertion of long-acting methods, and engage in facilitating conditions to access these contraceptives through public and private health systems in Brazil. This study is part of a project called ( from the Portuguese acronym). It aims to review the main characteristics of long-acting contraceptives and critically consider the current situation and future prospects to improve access to these methods, proposing practical recommendations of interest in the routine of gynecologists and obstetricians.

Adherencia, suspensión y eficacia terapéutica de los anticonceptivos hormonales en universitarios. Estudio transversal

“…En cuanto al motivo de no adherencia encontramos que la principal causa fue el cese de la vida sexual, resultado que no coincide con la investigación realizada en Medellín, donde la principal causa fue la presencia de eventos adversos (5). En lo referente a estas últimas como segunda causa de abandono terapéutico, esta la cefalea, aumento de peso y acné, resultado que no coincide con el estudio practicado en Cuba, donde predominaron los trastornos gastrointestinales, náuseas y epigastralgia 1. igualmente, no coincide con el realizado en México (25) Solamente un 17,9% de las encuestadas manifestaron haber utilizado los métodos de anticoncepción hormonal por más de 2 años, evidenciando esta situación una poca adherencia, lo cual puede conllevar a situaciones de riesgo en su contexto personal, familiar, educativo y social (13); esto a pesar de los esfuerzos del personal de salud, para la orientación y seguimiento de este método, se han reportado tasa de abandono a nivel nacional del 35% al 40% ( 5), ( 14) % y, a nivel internacional hasta del 62% (15).…”

Epidemiological profile and effectiveness of immediate postpartum contraception in Brazilian women

“…[5] Long-acting reversible contraceptives (LARCs), such as intrauterine devices and hormonal implants, are good options for immediate postpartum contraception. [6] Besides having high satisfaction rates, continued use, and high efficacy, [8] the WHO has released them for use within the first 48 hours after delivery, provided the woman has no contraindications and chooses to leave the maternity hospital with a contraceptive method. [6] A viable option of LARCs for use in the public health system in Brazil is the Copper Intrauterine Device (Cu-IUD) since they are available in the public health network, have high efficacy, have few side effects, and low cost.…”

“…Long-acting reversible contraceptives (LARCs), such as intrauterine devices and hormonal implants, are good options for immediate postpartum contraception. [6] Besides having high satisfaction rates, continued use, and high efficacy, [8] the WHO has released them for use within the first 48 hours after delivery, provided the woman has no contraindications and chooses to leave the maternity hospital with a contraceptive method. [6]…”

Intracesarean Postpartum Insertion of Intrauterine Contraceptive Device as an Alternative to Delayed Insertion: Safety and Complications

“…Long acting reversible contraception [LARC] is increasingly used to decrease the unintended pregnancies LARC methods, including the copper and levonorgestrel [LNG] intrauterine devices [IUDs] and the contraceptive implant, are described as first-line contraceptives for adolescents and adults by the American College of Obstetricians and Gynecologists [2] .…”