The Success of Long-Acting Reversible Contraceptives Compared With Oral Contraceptive Pills in an Adolescent Population [225

Abstract

INTRODUCTION: Long-acting reversible contraceptives (LARCs) have been shown to result in increased compliance in the general population compared with oral contraceptive pills; however, little is known specifically about adolescents regarding their method preference and experiences with LARCs. The objective of the study is to identify key differences between adolescent oral contraceptive pill and LARC users to show that the use of LARCs can and should be encouraged in this population. METHODS: Adolescents using oral contraceptive pills or LARCs solely for contraception were identified with demographic information, compliance, side effects reported, and method failures measured as primary outcomes. χ2 tests were used to compare groups for each outcome of interest. RESULTS: From January 2010 to November 2011, 240 patients met inclusion criteria. A total of 129 patients (53.8%) were oral contraceptive pill users, and 111 patients (46.2%) used LARCs, including depomedroxyprogesterone acetate (n=68, 61.3%), the etonogestrel implant (n=31, 27.9%), and the levonorgestrel intrauterine device (IUD) (n=12, 10.8%). There were no statistically significant differences in demographic information, compliance rates (P=.12), or discontinuation rates (P=.19). There was, however, more side effects noted with LARCs (P<.001), most notably breakthrough bleeding (73% of LARC users; 0% of oral contraceptive pill users). However, we found that those who discontinued the levonorgestrel IUD did not cite bleeding as the reason for discontinuation. CONCLUSION: In contrast to the adult population, compliance and discontinuation rates among adolescents using either oral contraceptive pills or LARCs were comparable despite reported side effects such as breakthrough bleeding. These results should be used to encourage consideration of the use of LARCs in the adolescent population.