Long-Acting Reversible Contraception (LARC) versus Short-Acting Methods: A Systematic Review of Effectiveness and Continuation

Abstract

Introduction: Long-acting reversible contraceptives (LARCs), including intrauterine devices and implants, offer highly effective, "fit and forget" contraception. This review compares their real-world effectiveness and continuation rates to short-acting hormonal methods (pills, patch, ring).

Methods: We conducted a systematic review of large, prospective cohort studies that compared pregnancy rates and method continuation rates between new users of LARC and short-acting methods.

Results: The analysis of major cohort studies showed that the typical-use failure rate of LARC methods was approximately 20 times lower than that of short-acting methods. One-year continuation rates for LARC methods were significantly higher (over 80%) compared to short-acting methods (around 50%).

Discussion: The superior effectiveness of LARC methods is due to their minimal reliance on user adherence. By removing the burden of daily, weekly, or monthly action, they provide more reliable contraception, which is reflected in higher continuation rates.

Conclusion: LARC methods are significantly more effective than short-acting methods in preventing unintended pregnancy and have higher continuation rates.