What qualities of long-acting reversible contraception do women perceive as desirable or undesirable? A systematic review
Jacqueline Coombe A B , Melissa L. Harris A and Deborah Loxton A
+ Author Affiliations
- Author Affiliations
A Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
B Corresponding author. Email: jacqueline.coombe@uon.edu.au
Sexual Health 13(5) 404-419 https://doi.org/10.1071/SH15189
Submitted: 24 September 2015 Accepted: 22 May 2016 Published: 29 July 2016
Abstract
Little research examining qualities of contraception that make them attractive or unattractive to users, particularly young women, exists. The aim of this study is to systemically review the evidence regarding desirable and undesirable qualities of long-acting reversible contraception (LARC), including intrauterine devices, the implant and the injection, as perceived by women. Five electronic databases were searched in May 2015 using terms related to LARC and method preference or decision-making. Studies were included if they concerned women aged 18–23 years from developed countries and reported on perceived positive or negative qualities of LARC. Thirty articles were deemed relevant. Five key themes emerged under which qualities were categorised; including: (1) impact on bleeding; (2) impact on the body; (3) device-specific characteristics; (4) general characteristics; and (5) perceptions and misbeliefs. Fit and forget, high efficacy and long-term protection were considered the top desirable qualities of LARC. Undesirable qualities varied among the LARC methods; however, irregular bleeding, painful insertion and removal procedure, weight gain and location in the body were among those most commonly reported. The contraceptive benefits of LARC, including their high efficacy and longevity, are generally considered to be positive qualities by women, while the potential impact of side-effects on the body are considered as negative qualities. This information is crucial in the clinical setting as it provides practitioners with a greater understanding of the qualities women do and do not like about LARC methods. Discussion about these qualities, positive and negative, during consultations about contraception may increase rates of uptake.
References
[1] Marie Stopes International. What women want: when faced with an unplanned pregnancy; 2006. Available online at: www.mariestopes.org.au/ [verified 6 November 2014].[2] Finer LB, Zolna MR. Declines in unintended pregnancy in the United States, 2008-2011. N Engl J Med 2016; 374 843–52.
| Declines in unintended pregnancy in the United States, 2008-2011.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC28XhtFGqsbfE&md5=e8b746d626ba3f58997796f574d8cdeeCAS | 26962904PubMed |
[3] Bajos N, Leridon H, Goulard H, Oustry P, Job‐Spira N, The COCON Group Contraception: from accessibility to efficiency. Hum Reprod 2003; 18 994–9.
| Contraception: from accessibility to efficiency.Crossref | GoogleScholarGoogle Scholar | 12721175PubMed |
[4] Wellings K, Jones KG, Mercer CH, Tanton C, Clifton S, Datta J, Copas AJ, Erens B, Gibson LJ, Macdowall W, Sonnenberg P, Phelps A, Johnson AM. The prevalence of unplanned pregnancy and associated factors in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet 2013; 382 1807–16.
| The prevalence of unplanned pregnancy and associated factors in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3).Crossref | GoogleScholarGoogle Scholar | 24286786PubMed |
[5] Finer L, Henshaw SK. Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspect Sex Reprod Health 2006; 38 90–6.
| Disparities in rates of unintended pregnancy in the United States, 1994 and 2001.Crossref | GoogleScholarGoogle Scholar | 16772190PubMed |
[6] Gray E, McDonald P. Using a reproductive life course approach to understand contraceptive method use in Australia. J Biosoc Sci 2010; 42 43–57.
| Using a reproductive life course approach to understand contraceptive method use in Australia.Crossref | GoogleScholarGoogle Scholar | 19852866PubMed |
[7] United Nations Department of Economic and Social Affairs Population Division. World Contraceptive Use 2014. New York: United Nations Population Division; 2014.
[8] Trussell J. Contraceptive failure in the United States. Contraception 2011; 83 397–404.
| Contraceptive failure in the United States.Crossref | GoogleScholarGoogle Scholar | 21477680PubMed |
[9] National Institute for Health and Care Excellence UK. Long-acting reversible contraception (update). 2014 Contract No.: NICE clinical guideline 30. London: National Institute for Health and Care Excellence; 2014.
[10] The American College of Obstetricians and Gynecologists. Committee Opinion. Increasing access to contraceptive implants and intrauterine devices to reduce unintended pregnancy. American College of Obstetricians and Gynecologists, 2015 Contract No.: 642. Washington: The American College of Obstetricians and Gynecologists; 2015.
[11] Family Planning Alliance Australia. Achieving change: increasing the use of effective long acting reversible contraception (LARC). 2014. Available online at: http://www.fpnsw.org.au/fpaa_larc_achieving_change_october_2014.pdf [verified 19 January 2015].
[12] Gray E, Arunachalam D. Patterns of contraceptive use. In Heard G, Arunachalam D, editors. Family formation in 21st century Australia. Dordrecht: Springer; 2015. pp. 123–40.
[13] Moreau C, Bohet A, Hassoun D, Teboul M, Bajos N, the FECOND Working Group. Trends and determinants of use of long-acting reversible contraception use among young women in France: results from three national surveys conducted between 2000 and 2010. Fertil Steril 2013; 100 451–8.
| Trends and determinants of use of long-acting reversible contraception use among young women in France: results from three national surveys conducted between 2000 and 2010.Crossref | GoogleScholarGoogle Scholar | 23663994PubMed |
[14] Daniels K, Daugherty J, Jones J. Current contraceptive status among women aged 15–44: United States, 2011–2013. Contract No.: 173. Atlanta: Centers for Disease Control and Prevention National Center for Health Statistics; 2014.
[15] Gomez AM, Clark JB. The relationship between contraceptive features preferred by young women and interest in IUDs: an exploratory analysis. Perspect Sex Reprod Health 2014; 46 157–63.
| The relationship between contraceptive features preferred by young women and interest in IUDs: an exploratory analysis.Crossref | GoogleScholarGoogle Scholar | 25040577PubMed |
[16] Weisberg E, Bateson D, McGeechan K, Mohapatra L. A three-year comparative study of continuation rates, bleeding patterns and satisfaction in Australian women using a subdermal contraceptive implant or progestogen releasing-intrauterine system. Eur J Contracept Reprod Health Care 2014; 19 5–14.
| A three-year comparative study of continuation rates, bleeding patterns and satisfaction in Australian women using a subdermal contraceptive implant or progestogen releasing-intrauterine system.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC2cXitVynsr8%3D&md5=5cc0f675ae8cda2af499065721edf5c4CAS | 24229367PubMed |
[17] Harvey C, Seib C, Lucke J. Continuation rates and reasons for removal among Implanon users accessing two family planning clinics in Queensland, Australia. Contraception 2009; 80 527–32.
| Continuation rates and reasons for removal among Implanon users accessing two family planning clinics in Queensland, Australia.Crossref | GoogleScholarGoogle Scholar | 19913146PubMed |
[18] Moreau C, Cleland K, Trussell J. Contraceptive discontinuation attributed to method dissatisfaction in the United States. Contraception 2007; 76 267–72.
| Contraceptive discontinuation attributed to method dissatisfaction in the United States.Crossref | GoogleScholarGoogle Scholar | 17900435PubMed |
[19] Lakha F, Glasier AF. Continuation rates of Implanon in the UK: data from an observational study in a clinical setting. Contraception 2006; 74 287–9.
| Continuation rates of Implanon in the UK: data from an observational study in a clinical setting.Crossref | GoogleScholarGoogle Scholar | 16982226PubMed |
[20] Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement. PLoS Med 2009; 6 1-6
| Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement.Crossref | GoogleScholarGoogle Scholar |
[21] Fiebig DG, Knox S, Viney R, Haas M, Street DJ. Preferences for new and existing contraceptive products. Health Econ 2011; 20 35–52.
| Preferences for new and existing contraceptive products.Crossref | GoogleScholarGoogle Scholar | 21809412PubMed |
[22] Campo S, Askelson NM, Spies EL, Losch M. Preventing unintended pregnancies and improving contraceptive use among young adult women in a rural, midwestern state: health promotion implications. Women Health 2010; 50 279–96.
| Preventing unintended pregnancies and improving contraceptive use among young adult women in a rural, midwestern state: health promotion implications.Crossref | GoogleScholarGoogle Scholar | 20512746PubMed |
[23] Wigginton B, Harris ML, Loxton D, Lucke J. A qualitative analysis of women’s explanations for changing contraception: the importance of non-contraceptive effects. J Fam Plann Reprod Health Care 2016;
| A qualitative analysis of women’s explanations for changing contraception: the importance of non-contraceptive effects.Crossref | GoogleScholarGoogle Scholar | 26811435PubMed |
[24] Hoggart L, Newton VL. Young women’s experiences of side-effects from contraceptive implants: a challenge to bodily control. Reprod Health Matters 2013; 21 196–204.
| Young women’s experiences of side-effects from contraceptive implants: a challenge to bodily control.Crossref | GoogleScholarGoogle Scholar | 23684202PubMed |
[25] Newton VL, Hoggart L. Hormonal contraception and regulation of menstruation: a study of young women’s attitudes towards ‘having a period’. J Fam Plann Reprod Health Care 2015; 41 210–5.
| 25349229PubMed |
[26] Higgins JA, Hirsch JS. The pleasure deficit: revisiting the “sexuality connection” in reproductive health. Perspect Sex Reprod Health 2007; 39 240–7.
| The pleasure deficit: revisiting the “sexuality connection” in reproductive health.Crossref | GoogleScholarGoogle Scholar | 18093041PubMed |
[27] Higgins JA, Hirsch JS. Pleasure, power, and inequality: incorporating sexuality into research on contraceptive use. Am J Public Health 2008; 98 1803–13.
| Pleasure, power, and inequality: incorporating sexuality into research on contraceptive use.Crossref | GoogleScholarGoogle Scholar | 18703457PubMed |
[28] Fennell J. “And isn’t that the point?”: pleasure and contraceptive decisions. Contraception 2014; 89 264–70.
| “And isn’t that the point?”: pleasure and contraceptive decisions.Crossref | GoogleScholarGoogle Scholar | 24332430PubMed |
[29] Glasier A, Scorer J, Bigrigg A. Attitudes of women in Scotland to contraception: a qualitative study to explore the acceptability of long-acting methods. J Fam Plann Reprod Health Care 2008; 34 213–7.
| Attitudes of women in Scotland to contraception: a qualitative study to explore the acceptability of long-acting methods.Crossref | GoogleScholarGoogle Scholar | 18854066PubMed |
[30] Spies EL, Askelson NM, Gelman E, Losch M. Young women’s knowledge, attitudes, and behaviors related to long-acting reversible contraceptives. Women’s Health Issues 2010; 20 394–9.
| Young women’s knowledge, attitudes, and behaviors related to long-acting reversible contraceptives.Crossref | GoogleScholarGoogle Scholar | 21050998PubMed |
[31] Kavanaugh ML, Frohwirth L, Jerman J, Popkin R, Ethier K. Long-acting reversible contraception for adolescents and young adults: patient and provider perspectives. J Pediatr Adolesc Gynecol 2013; 26 86–95.
| Long-acting reversible contraception for adolescents and young adults: patient and provider perspectives.Crossref | GoogleScholarGoogle Scholar | 23287602PubMed |
[32] Moreau C, Bohet A, Hassoun D, Ringa V, Bajos N. IUD use in France: women’s and physician’s perspectives. Contraception 2014; 89 9–16.
| IUD use in France: women’s and physician’s perspectives.Crossref | GoogleScholarGoogle Scholar | 24239330PubMed |
[33] Okpo E, Allerton L, Brechin S. ‘But you can’t reverse a hysterectomy!’ Perceptions of long acting reversible contraception (LARC) among young women aged 16–24 years: a qualitative study. Public Health 2014; 128 934–9.
| ‘But you can’t reverse a hysterectomy!’ Perceptions of long acting reversible contraception (LARC) among young women aged 16–24 years: a qualitative study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC2M3lvVentw%3D%3D&md5=551cebf1ee3a52d566967917fe4e20e2CAS | 25369357PubMed |
[34] Bracken J, Graham CA. Young women’s attitudes towards, and experiences of, long-acting reversible contraceptives. Eur J Contracept Reprod Health Care 2014; 19 276–84.
| Young women’s attitudes towards, and experiences of, long-acting reversible contraceptives.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC2cXht1aht7%2FO&md5=1a10f1a70cd4a5495f6895fc30370b69CAS | 24882426PubMed |
[35] Rubin SE, Winrob I. Urban female family medicine patients’ perceptions about intrauterine contraception. J Women’s Health 2010; 19 735–40.
| Urban female family medicine patients’ perceptions about intrauterine contraception.Crossref | GoogleScholarGoogle Scholar |
[36] Hladky KJ, Allsworth JE, Madden T, Secura GM, Peipert JF. Women’s knowledge about intrauterine contraception. Obstet Gynecol 2011; 117 48–54.
| Women’s knowledge about intrauterine contraception.Crossref | GoogleScholarGoogle Scholar | 21173643PubMed |
[37] Anderson N, Steinauer J, Valente T, Koblentz J, Dehlendorf C. Women’s social communication about IUDs: a qualitative analysis. Perspect Sex Reprod Health 2014; 46 141–8.
| Women’s social communication about IUDs: a qualitative analysis.Crossref | GoogleScholarGoogle Scholar | 24894575PubMed |
[38] McNicholas C, Madden T, Secura G, Peipert JF. The contraceptive CHOICE project round up: what we did and what we learned. Clin Obstet Gynecol 2014; 57 635–43.
| The contraceptive CHOICE project round up: what we did and what we learned.Crossref | GoogleScholarGoogle Scholar | 25286295PubMed |
[39] Family Planning Alliance Australia. Long acting reversible contraception (LARC) position statement; 2014. Available online at: http://www.fpnsw.org.au/fpaa_larc_statement_october_2014.pdf [verified 22 January 2015].
[40] Gomez AM, Fuentes L, Allina A. Women or LARC first? Reproductive autonomy and the promotion of long-acting reversible contraceptive methods. Perspect Sex Reprod Health 2014; 46 171–5.
| Women or LARC first? Reproductive autonomy and the promotion of long-acting reversible contraceptive methods.Crossref | GoogleScholarGoogle Scholar | 24861029PubMed |
[41] Garrett CC, Keogh LA, Kavanagh A, Tomnay J, Hocking JS. Understanding the low uptake of long-acting reversible contraception by young women in Australia: a qualitative study. BMC Women’s Health 2015; 15 1–10.
| Understanding the low uptake of long-acting reversible contraception by young women in Australia: a qualitative study.Crossref | GoogleScholarGoogle Scholar |
[42] Hoggart L, Louise Newton V, Dickson J. “I think it depends on the body, with mine it didn’t work”: explaining young women’s contraceptive implant removal. Contraception 2013; 88 636–40.
| “I think it depends on the body, with mine it didn’t work”: explaining young women’s contraceptive implant removal.Crossref | GoogleScholarGoogle Scholar | 23829976PubMed |
[43] Rose SB, Cooper AJ, Baker NK, Lawton B. Attitudes toward long-acting reversible contraception among young women seeking abortion. J Women’s Health 2011; 20 1729–35.
| Attitudes toward long-acting reversible contraception among young women seeking abortion.Crossref | GoogleScholarGoogle Scholar |
[44] Teal SB, Sheeder J. IUD use in adolescent mothers: retention, failure and reasons for discontinuation. Contraception 2012; 85 270–4.
| IUD use in adolescent mothers: retention, failure and reasons for discontinuation.Crossref | GoogleScholarGoogle Scholar | 22067773PubMed |
[45] Whitaker AK, Johnson LM, Harwood B, Chiappetta L, Creinin MD, Gold MA. Adolescent and young adult women’s knowledge of and attitudes toward the intrauterine device. Contraception 2008; 78 211–7.
| Adolescent and young adult women’s knowledge of and attitudes toward the intrauterine device.Crossref | GoogleScholarGoogle Scholar | 18692611PubMed |
[46] Brockmeyer A, Kishen M, Webb A. Experience of IUD/IUS insertions and clinical performance in nulliparous women–a pilot study. Eur J Contracept Reprod Health Care 2008; 13 248–54.
| Experience of IUD/IUS insertions and clinical performance in nulliparous women–a pilot study.Crossref | GoogleScholarGoogle Scholar | 18821462PubMed |
[47] Dickerson LM, Diaz VA, Jordon J, Davis E, Chirina S, Goddard JA, Carr KB, Carek PJ. Satisfaction, early removal, and side effects associated with long-acting reversible contraception. Fam Med 2013; 45 701–7.
| 24347187PubMed |
[48] Diedrich JT, Desai S, Zhao Q, Secura G, Madden T, Peipert JF. Association of short-term bleeding and cramping patterns with long-acting reversible contraceptive method satisfaction. Am J Obstet Gynecol 2015; 212 50.e1–8.
| Association of short-term bleeding and cramping patterns with long-acting reversible contraceptive method satisfaction.Crossref | GoogleScholarGoogle Scholar |
[49] Fleming KL, Sokoloff A, Raine TR. Attitudes and beliefs about the intrauterine device among teenagers and young women. Contraception 2010; 82 178–82.
| Attitudes and beliefs about the intrauterine device among teenagers and young women.Crossref | GoogleScholarGoogle Scholar | 20654760PubMed |
[50] Foster DG, Grossman D, Turok DK, Peipert JF, Prine L, Schreiber CA, Jackson AV, Barar RE, Bimla Schwarz E. Interest in and experience with IUD self-removal. Contraception 2014; 90 54–9.
| Interest in and experience with IUD self-removal.Crossref | GoogleScholarGoogle Scholar | 24613370PubMed |
[51] Gubrium A. “I’ve lost my mojo, baby”: a narrative perspective on the effect of Depo-Provera on libido. Sex Res Social Policy 2011; 8 321–34.
| “I’ve lost my mojo, baby”: a narrative perspective on the effect of Depo-Provera on libido.Crossref | GoogleScholarGoogle Scholar |
[52] Kane R, Irving G, Brown S, Parkes N, Walling M, Killick S. Long-acting, reversible and permanent methods of contraception: insight into women’s choice of method. Qual Prim Care 2009; 17 107–14.
| 19416603PubMed |
[53] Marions L, Lövkvist L, Taube A, Johansson M, Dalvik H, Øverlie I. Use of the levonorgestrel releasing-intrauterine system in nulliparous women – a non-interventional study in Sweden. Eur J Contracept Reprod Health Care 2011; 16 126–34.
| Use of the levonorgestrel releasing-intrauterine system in nulliparous women – a non-interventional study in Sweden.Crossref | GoogleScholarGoogle Scholar | 21417562PubMed |
[54] Michie L, Cameron ST, Glasier A, Wellings K, Loudon J. Myths and misconceptions about intrauterine contraception among women seeking termination of pregnancy. J Fam Plann Reprod Health Care 2014; 40 36–40.
| Myths and misconceptions about intrauterine contraception among women seeking termination of pregnancy.Crossref | GoogleScholarGoogle Scholar | 23709608PubMed |
[55] Peipert JF, Zhao QH, Allsworth JE, Petrosky E, Madden T, Eisenberg D, Secura G. Continuation and satisfaction of reversible contraception. Obstet Gynecol 2011; 117 1105–13.
| Continuation and satisfaction of reversible contraception.Crossref | GoogleScholarGoogle Scholar | 21508749PubMed |
[56] Riney S, OShea B, Forde A. Etonogestrel implant as a contraceptive choice; patient acceptability and adverse effect profile in a general practice setting. Ir Med J 2009; 102 24–5.
| 1:STN:280:DC%2BD1M3gvVaquw%3D%3D&md5=1e21a92ecfe080a0d84bde284f774551CAS | 19284015PubMed |
[57] Rose SB, Cooper AJ, Baker NK, Lawton B. Attitudes toward long-acting reversible contraception among young women seeking abortion. J Women’s Health 2011; 20 1729–35.
| Attitudes toward long-acting reversible contraception among young women seeking abortion.Crossref | GoogleScholarGoogle Scholar |
[58] Sonalkar S, Hou M, Borgatta L. Administration of the etonogestrel contraceptive implant on the day of mifepristone for medical abortion: a pilot study. Contraception 2013; 88 671–3.
| Administration of the etonogestrel contraceptive implant on the day of mifepristone for medical abortion: a pilot study.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXhsVKkt7bJ&md5=7c61cc83185fc42b642fb2a0f179424eCAS | 24028749PubMed |
[59] Venkat P, Masch R, Ng E, Cremer M, Richman S, Arslan A. Knowledge and beliefs about contraception in urban Latina women. J Community Health 2008; 33 357–62.
| Knowledge and beliefs about contraception in urban Latina women.Crossref | GoogleScholarGoogle Scholar | 18498045PubMed |
[60] Weisberg E, Bateson D, McGeechan K, Mohapatra L. A three-year comparative study of continuation rates, bleeding patterns and satisfaction in Australian women using a subdermal contraceptive implant or progestogen releasing-intrauterine system. Eur J Contracept Reprod Health Care 2014; 19 5–14.
| A three-year comparative study of continuation rates, bleeding patterns and satisfaction in Australian women using a subdermal contraceptive implant or progestogen releasing-intrauterine system.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC2cXitVynsr8%3D&md5=5cc0f675ae8cda2af499065721edf5c4CAS | 24229367PubMed |
[61] Weisberg E, Fraser I. Australian women’s experience with Implanon. Aust Fam Physician 2005; 34 694–6.
| 16113711PubMed |
[62] Whitaker AK, Johnson LM, Harwood B, Chiappetta L, Creinin MD, Gold MA. Adolescent and young adult women’s knowledge of and attitudes toward the intrauterine device. Contraception 2008; 78 211–7.
| Adolescent and young adult women’s knowledge of and attitudes toward the intrauterine device.Crossref | GoogleScholarGoogle Scholar | 18692611PubMed |
[63] Wong RC, Bell RJ, Thunuguntla K, McNamee K, Vollenhoven B. Implanon users are less likely to be satisfied with their contraception after 6 months than IUD users. Contraception 2009; 80 452–6.
| Implanon users are less likely to be satisfied with their contraception after 6 months than IUD users.Crossref | GoogleScholarGoogle Scholar | 19835719PubMed |
[64] Xu X, Macaluso M, Frost J, Anderson JE, Curtis K, Grosse SD. Characteristics of users of intrauterine devices and other reversible contraceptive methods in the United States. Fertil Steril 2011; 96 1138–44.
| Characteristics of users of intrauterine devices and other reversible contraceptive methods in the United States.Crossref | GoogleScholarGoogle Scholar | 21917255PubMed |
