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Contraception

Helping your patients make the right choice

With rising abortion rates, particularly among all ages 22 and above, over the last 10 years, the largest increase are amongst women aged 30-34. Therefore, there is a clear need to offer the most effective contraceptive methods. In a quantitative survey of over 430 women and their experiences of unintended pregnancy and abortion, over half were using contraception at the time they became pregnant. Long-acting methods can be the most effective form of contraception because they do not rely on user compliance.

Pill compliance is a common struggle for women

For every 100 women that choose to take the pill this year, nine could become pregnant due to missed-pill moments.

Long-acting methods such as intrauterine systems (IUS) offer birth control with the highest available efficacy and are one of the most effective contraceptive methods because their effectiveness is independent of user compliance.

If you are a fitter of IUS, visit Fitter resources which covers all the practical aspects of the IUS/IUD fitting process, including preparation and loading advice.

Fitter Resources

Choose an IUS that best meets her needs

	Jaydess®▼ 13.5mg intrauterine delivery system (levonorgestrel)	Kyleena® 19.5mg intrauterine delivery system (levonorgestrel)	Mirena® 52mg intrauterine delivery system (levonorgestrel)
Indication	Contraception for up to 3 years	Contraception for up to 5 years.	Contraception for up to 8 years. Treatment of HMB for up to 5 years use, continued use may be considered for up to 8 years if symptoms have not returned.Endometrial protection during HRT for 4 years.
Pearl Index (efficacy)	Year 1:0.41 3-years: 0:33	Year 1: 0.16 5-years: 0.29	Year 1: 0.21 Years 6-8: 0.28
Contraceptive failure rate	0.4% at 1 year 0.9% over 3 years	0.2% at 1 year 1.4% over 5 years	0.2% at 1 year 0.71% over 5 years 0.68 over 6-8 years
Total levonorgestrel (LNG) content (mg)	13.5	19.5	52
Average in vivo LNG release rate over the first year of use	8 μg/24 hours	12.6 μg/24 hours	20 μg/24 hours*
% of women experiencing amenorrhoea and infrequent bleeding at 1 year post insertion	Amenorrhoea: 6% infrequent bleeding: 20%	Amenorrhoea: 12% infrequent bleeding: 26%	Amenorrhoea: 16% infrequent bleeding: 57%
T-frame size (mm)	28 × 30	28 × 30	32 × 32
Placement tube diameter size (mm)	3.8	3.8	4.4
Colour of monofilament threads	Brown	Blue	Brown
Differentiator in imaging techniques:silver ring	Improved visibility on ultrasound	Improved visibility on ultrasound	-

^{* Initial estimated in vivo release rate}

PP-PF-WHC-IUS-GB-0013 | August 2024

References

1
Department of Health Abortion Statistics England and Wales 2021. Available at: https://www.gov.uk/government/statistics/abortion-statistics-for-england-and-wales-2021/abortion-statistics-england-and-wales-2021. [Last accessed: June 2024]
2
Bury, Louise; Hoggart, Lesley and Newton, Victoria Louise (2015). Young women’s experiences of unintended pregnancy and abortion: key findings. The Open University, Milton Keynes, UK. Available at: https://oro.open.ac.uk/45138/1/MSI_key-findings_10-15_email.pdf (Last Accessed February 2024)
3
Cristobal I, et al. Eur J Obstet Gynecol Reprod Biol 2015;190:58–64.
4
NHS. How effective is contraception at preventing pregnancy? - Your contraception guide [online]. Updated 30 June 2017. Available at: https://www.nhs.uk/conditions/contraception/how-effective-contraception/ (Last Accessed February 2024)