Version May 2024
| Characteristics | Copper IUD | Levonorgestrel-releasing IUD | Contraceptive pill, patch, or ring | Etonogestrel implant | DMPA | Male condom | Diaphragm |
| Pregnancy rate in the first year of use in a typical patient | <1 | <1 | 4 to 7 | <1 | 4 to 7 | 13 | 13 |
| Duration of efficacy | 10 years | 3 to 5 years (depending on type) | Use daily (pill), weekly (patch), monthly (ring) | 3 years | 12 weeks | Single use at the time of each coital act | Reusable; must be inserted before coitus and used with a spermicidal cream/gel |
| Hormonal exposure | None | Progestin | Estrogen and progestin | Progestin | Progestin | None | None |
| Effect on menses | May be heavier | Lighter, irregular especially in first 3 to 6 months | Lighter, regular predictable withdrawal bleeding with cyclic use | Lighter, irregular | Lighter, irregular | None | None |
| Unscheduled bleeding/spotting | Yes | Yes | Yes | Yes | Yes | No | No |
| Not a good choice for otherwise healthy patients* with: | Heavy or painful periods, iron deficiency anemia, severe distortion of uterine cavity, copper allergy or Wilson disease, active pelvic infection | Severe distortion of uterine cavity, active pelvic infection, poor tolerance of amenorrhea or unscheduled bleeding, sensitive to hormonal side effects | Contraindications to using exogenous estrogen or who are sensitive to estrogen-related side effects (eg, nausea, breast tenderness, headache, etc), patients over 35 years who smoke | Poor tolerance of amenorrhea or unscheduled bleeding | Poor tolerance of amenorrhea or unscheduled bleeding or known preexisting low bone mineral density, or who want to get pregnant quickly upon discontinuation | Sensitivity or allergy to latex (non-latex condoms are available), male partner who won't use the method | Sensitivity or allergy to latex (non-latex diaphragms are available), pelvic relaxation, difficulty with insertion or care of the diaphragm |
| Access | Must be inserted and removed by a clinician | Must be inserted and removed by a clinician | Prescription | Must be inserted and removed through a tiny skin incision by a clinician with special training | Injection by a clinician | Over-the-counter | Prescription |
| Selected adverse events | Uterine perforation, expulsion, increased risk of pelvic infection in the first 20 days after insertion | Uterine perforation, expulsion, increased risk of pelvic infection in the first 20 days after insertion | Increased risk of venous thrombosis, hepatic adenoma | Infection or scarring at insertion/removal site, difficult removal | May cause weight gain, mood changes, and osteopenia (with long-term use) | Condom may break | May increase risk of urinary tract infection |
| Selected advantages | Highly effective long-acting method that can be used by patients who must or choose to avoid exogenous hormones | Reduction in menorrhagia, dysmenorrhea, and endometrial hyperplasia | Benefits of estrogen include a reduction in dysmenorrhea, menorrhagia, acne vulgaris, and vasomotor symptoms (perimenopausal patients) | Highly effective long-acting method that can be used by patients who must or choose to avoid estrogen | Effective prolonged contraception that can be used by patients who must or choose to avoid estrogen | Best protection against sexually transmitted infections | Low-cost and reusable |
IUD: intrauterine device; DMPA: depot medroxyprogesterone acetate.
* For patients with current or prior medical disorders, refer to a resource such as United States Medical Eligibility Criteria for Contraceptive Use (USMEC) (available at www.cdc.gov).آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
