Long-acting Reversible Contraceptive - Efficacy

Efficacy

The effectiveness of LARC methods has been shown to be superior to other types of birth control. A study in 2012, with the largest cohort of IUD and implant users to date, found that the risk of contraceptive failure for those using oral contraceptive pills, the birth control patch, or the vaginal ring was 20 times higher than the risk for those using long-acting reversible contraception. For those under 21, who typically have lower adherence to drug regimens, the risk is twice as high as the risk among older participants.

The discrepancy between LARC methods and other forms of birth control lies in the difference between "perfect use" and "typical use". Perfect use indicates complete adherence to medication schedules and guidelines. Typical use describes effectiveness in real-world conditions, where patients may not fully adhere to medication regimens. LARC methods require little to no user action after insertion; therefore, LARC perfect use failure rates are the same as their typical use failure rates. LARC failure rates rival that of sterilization, but unlike sterilization LARC methods are reversible. Other reversible methods, such as oral contraceptive pills, the birth control patch, or the vaginal ring require daily, weekly, or monthly action by the user. While the perfect use failure rates of those methods may equal LARC methods, the typical use failure rates are significantly higher. Even methods such as the DMPA injection require users to return to their provider every 12 weeks for the intramuscular shot or every 4 weeks for the subcutaneous shot. So, DMPA typical use failure rates are also higher than perfect use failure rates as more than 40% of women discontinue DMPA in the first year. In both effectiveness and continuation, LARC methods are considered the first-line option for contraception.