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Free-of-charge long-acting reversible contraception: Two-year discontinuation, its risk factors, and reasons

American Journal of Obstetrics and Gynecology Jul 22, 2020

Saloranta TH, Gyllenberg FK, But A, et al. - The residents of the city of Vantaa, Finland, are provided their first long-acting reversible contraceptive method (levonorgestrel-releasing intrauterine system, implant, and copper intrauterine device) free of charge since 2013. Researchers here investigated the 2-year cumulative discontinuation rates of long-acting reversible contraceptive methods in this real-world setting. Further, they investigated factors linked with discontinuation and evaluated the reasons for discontinuation. In this retrospective register-based cohort study, they assessed 2,026 nonsterilized women aged 15 to 44 years, who initiated a free-of-charge long-acting contraceptive method. During the 2 -year follow-up, discontinuation was recorded in 514 women, indicating a cumulative discontinuation rate of 28.3 per 100 women-years. Discontinuation was more frequent in correlation with the use of implants and copper intrauterine devices than with the use of levonorgestrel-releasing intrauterine system. Likelihood for discontinuation seemed higher among women younger than 30 years and those who gave birth in the preceding year, spoke a native language other than Finnish or Swedish, or had a history of sexually transmitted infections. Discontinuation due to bleeding disturbances was least frequent in correlation with the levonorgestrel-releasing intrauterine system.

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