How do women and health care professionals view hormonal long-acting reversible contraception? Results from an international survey

Figures & data

Figure 1. Primary contraceptive method used by women aged <25 years, 25–34 years and ≥35 years. Oral: combined oral contraceptives and progestogen-only pills; SARCs: vaginal ring, patch, 3-month injectable; hormonal LARCs: LNG 20, LNG-IUS 20, LNG-IUS 8, ENG implants; non-hormonal methods: condoms, spermicide, natural methods. ENG: etonogestrel; IUD: intrauterine device; IUS: intrauterine system; LARC: long-acting reversible contraception; LNG: levonorgestrel; SARC: short-acting reversible contraception.

Table 1. Contraceptive use data collected from women completing the online survey.

	USA	Canada	Germany	France	UK	Belgium	Czech Republic	Total
Women completing the online survey, n (%)	2000	1001	1002	1000	1000	500	400	6903
LNG-IUS 20	60 (3)	30 (3)	33 (3)	70 (7)	36 (4)	37 (7)	17 (4)	283 (4)
LNG 20	0 (0)	0 (0)	0 (0)	0 (0)	1 (<1)	2 (<1)	0 (0)	3 (<1)
LNG-IUS 8	5 (<1)	3 (<1)	5 (<1)	1 (<1)	1 (<1)	5 (1)	1 (<1)	21 (<1)
Etonogestrel implant	17 (1)	0 (0)	5 (<1)	26 (3)	23 (2)	2 (<1)	0 (0)	73 (1)
Copper intrauterine device	26 (1)	17 (2)	20 (2)	48 (5)	22 (2)	5 (1)	4 (1)	142 (2)
Combined oral contraceptives	306 (15)	146 (15)	188 (19)	272 (27)	149 (15)	160 (32)	80 (20)	1301 (19)
Progesterone-only pills	20 (1)	11 (1)	62 (6)	38 (4)	49 (5)	18 (4)	16 (4)	214 (3)
Vaginal ring	15 (1)	10 (1)	10 (1)	5 (1)	1 (<1)	12 (2)	4 (1)	57 (1)
Patch	8 (<1)	6 (1)	0 (0)	1 (<1)	3 (<1)	3 (1)	3 (1)	24 (<1)
3-month injectable	33 (2)	17 (2)	10 (1)	0 (0)	17 (2)	5 (1)	4 (1)	86 (1)
Condoms	166 (8)	105 (10)	144 (14)	78 (8)	117 (12)	29 (6)	49 (12)	688 (10)
Spermicide	5 (<1)	0 (0)	3 (<1)	3 (<1)	1 (<1)	1 (<1)	5 (1)	18 (<1)
Natural methods^a	95 (5)	56 (6)	45 (4)	31 (3)	32 (3)	13 (3)	43 (11)	315 (5)
‘Other’ contraception	14 (1)	12 (1)	12 (1)	4 (<1)	3 (<1)	3 (1)	5 (1)	53 (1)
Eligible, but NOT using contraception	424 (21)	203 (20)	168 (17)	170 (17)	208 (21)	73 (15)	66 (17)	1312 (19)
Ineligible for contraception and did not provide a method (e.g., sterile, currently pregnant, post-menopausal)	806 (40)	385 (38)	297 (30)	253 (25)	337 (34)	132 (26)	103 (26)	2313 (34)

^a Natural methods included: withdrawal method, rhythm method, standard/calendar days and natural family planning.

Figure 2. Favourability of current contraceptive method in women using a hormonal intrauterine system or oral contraceptives*. Favourability rated on a 1–7 scale where ‘1’ is ‘Not at all favourable’ and ‘7’ is ‘Very favourable’. *Subset of women who had previously stated that they had spoken to someone else about IUS (n = 248) or oral contraceptives (n = 932). IUS = LNG-IUS 20, LNG 20 and LNG-IUS 8. IUS: intrauterine system; LNG: levonorgestrel.

Figure 3. Women’s aided awareness* of contraceptive methods. *Recognition of specific contraceptive methods from a list of possible methods (including examples of country-specific brand names) offered as a prompt. IUS = LNG-IUS 20, LNG 20 and LNG-IUS 8. IUD: intrauterine device; IUS: intrauterine system; LNG: levonorgestrel.

Table 2. Long-acting reversible contraceptive use data collected from anonymous records

	USA	Canada	Germany	France	UK	Belgium	Czech Republic	Total
Patient records, n	450	180	225	225	225	150	150	1605
LNG-IUS 20	150 (33)	90 (50)	75 (33)	75 (33)	78 (35)	50 (33)	64 (43)	582 (36)
LNG 20	37 (8)	–	–	–	5 (2)	25 (17)	11 (7)	78 (5)
LNG-IUS 8	150 (33)	90 (50)	75 (33)	75 (33)	68 (30)	50 (33)	75 (50)	583 (36)
Etonogestrel implant	113 (25)	–	75 (33)	75 (33)	74 (33)	25 (17)	–	362 (23)

IUS: intrauterine system; LNG: levonorgestrel.

Figure 4. Contraceptive use immediately before current long-acting reversible contraception.

Other/don’t know;

No previous hormonal contraception;

No immediately prior contraception (on a break);

Oral (combined oral contraceptive or progesterone-only pill);

Other short-acting reversible contraception (vaginal ring, patch, 3-month injectable);

Long-acting reversible contraception (LNG-IUS, IUD, implant). *Because of the low numbers of users of levonorgestrel (LNG 20; total content 52 mg levonorgestrel [Liletta^®/Levosert^®]), data were combined with those for the levonorgestrel intrauterine system (LNG-IUS 20; total content 52 mg levonorgestrel [Mirena^®]). IUD: intrauterine device; IUS: intrauterine system; LNG: levonorgestrel.

Figure 5. Physician-perceived satisfaction of women with long-acting reversible contraception. Satisfaction rated on a 1–7 scale where ‘1’ is ‘Not at all satisfied’ and ‘7’ is ‘Extremely satisfied’. IUS: intrauterine system; LARC: long-acting reversible contraception; LNG: levonorgestrel.