IUD, Implants More Effective Birth Control Than Pill, Patch or Ring, New Study Shows


The IUD: Tiny, but powerful.
  • The IUD: Tiny, but powerful.

If you don't want to get knocked up unexpectedly, your best bet, according to a new study out of Washington University Medical School, is a long-term method of contraception, namely an IUD or an implant. Either one of these methods is twenty times more effective than shorter-term methods like the Pill, the Patch or the NuvaRing.

Consider that of the approximately 3 million pregnancies that happen in the U.S. every year, half of them are unintended, and half of those come from birth control failure. That amounts to 750,000 accidental pregnancies every year from misused birth control.

Unfortunately, since you need a professional to help you insert an IUD or an implant, the upfront cost is higher, around $1,000. Over time -- implants last three years and IUD's either five or ten, depending on which kind you get -- they'll end up costing less than the other methods, which go for as much as $80 a month.

Obviously, whatever kind of birth control you get is cheaper than paying for the care and feeding of an infant, but unless they're covered by health insurance, the more effective varieties are out of the reach of many women. In fact, only 5.5 percent of women who use some sort of contraceptive use an IUD or implant.

The study, which took place between August 2007 and September 2011, included nearly 7,500 women recruited from around the St. Louis area. They ranged in age from 14 to 45 and represented a variety of ethnicities and income and education levels. None of them had any desire to become pregnant and all were sexually active, or planning to become sexually active within six months of joining the study.

  • Peipert

Each participant got to choose her preferred form of birth control; all costs were covered by the study, underwritten, says Dr. Jeffrey Peipert, one of the researchers, by a large company that wishes to remain anonymous but also to find and promote the most useful method of birth control. The vast majority of the women chose the IUD or implant.

Over the course of the study, there were 334 unplanned pregnancies due to contraceptive failure. Among Pill, Patch and Ring users, the failure rate was 4.55 percent; among IUD and implant users, it was .27 percent.

"There's more room for error with the Pill," explains Peipert. "We're humans. That's why clinicians say you should put the pills next to your toothbrush, to make it a habit. Otherwise, you may miss one or two. It's more about human nature." The same goes for the Patch and Ring, which have to replaced every month. By contrast, "with the longer-acting methods, you don't have to worry once they're placed."

This is especially useful information for younger women. In the study, the birth control failure rate of women 21 years old and younger was nearly twice that of the older women.

"Twenty-five percent of young women miss two or more pills a month," says Peipert. "If there was a medicine for cancer or heart disease that was twenty-fold more effective than what you're using, you always go with the more effective one."

Yes, clearly IUD's and implants are the way to go if you don't want kids for several years. But the cost, Dr. Peipert, the cost!

"It's a major barrier for women today," Peipert admits. "But in California, where contraceptives are free of charge, there's been a marked reduction in unplanned pregnancies. It's costly, but we're already paying, with reduced birthweights, increased risk of disease. Prevention is the best way. One dollar spent on prevention saves three to four dollars down the road."

Read the full study in the most recent issue of the New England Journal of Medicine.

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