Hormonal implants, matchstick-sized rods that are placed under the skin surface, emit a progestin type hormone for three years. The implants are "the most effective method of reversible contraception," with a failure rate for typical users of 0.05 percent, according to information in the Practice Bulletin. IUDs have a failure rate of less than 1 percent.
IUDs and hormonal implants cost between $400 and $750, not including the doctor's fee, with at least part of the expense covered by most insurance plans, said Jacobs.
In the 1970s, the Dalkon shield, a brand of IUD with a unique design, was taken off the market after being linked to pelvic inflammatory disease and infertility caused by sexually transmitted disease in women using the device, said Jacobs.
Some types of copper IUDs were later linked to pelvic inflammatory disease as well, although some experts say the risk has been overestimated.
There was no similar concern about implants, which have been in use for many years, he said.
"From both a patient standpoint and a social standpoint," IUDs and implants are beneficial because they "keep young women in school" instead of falling into a life of poverty that can follow unintended pregnancies and a lack of education, said Jacobs.
To learn more about the guidelines, visit the American Congress of Obstetricians and Gynecologists.
SOURCES: Adam Jacobs, M.D., medical director, family planning division, Mount Sinai Medical Center, New York City; Jill Rabin, M.D., chief, ambulatory care division, and head of urogynecology, North Shore Long Island Jewish Medical Center, New Hyde Park, N.Y.; July 2011, Obstetrics & Gynecology
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