Long-acting reversible contraception

Scott Wilkes

doi:10.3399/bjgp13X671560

I would like to draw the attention of your readers to the conclusions of a paper recently published in the Journal of Family Planning and Reproductive Healthcare,1 the conclusion of which is that the levonorgestrel-releasing intrauterine system (LNG IUS; Mirena^® Bayer) should be offered first-line without restriction to young and nulliparous women.

It is now 8 years since the National Institute for Health and Care Excellence (NICE) issued its guidance encouraging increased access to long-acting reversible contraception (LARC).2 LARC methods are more cost-effective than the combined oral contraceptive pill and will reduce the number of unintended pregnancies. This includes the ‘fit and forget’ use of the IUS.3 The IUD/IUS is not contraindicated in young nulliparous women of any age and this message seems not to be reaching our GP colleagues with nine out 10 GPs still advising women to use the contraceptive pill as a first-line choice for young nulliparous women.4

The overriding message is that the levonorgestrel-releasing IUS is a first-line contraceptive option for young and nulliparous women.

REFERENCES

1.↵
1. Armitage CM,
2. Mitchell C,
3. Wigan C,
4. Smith DA
(2013) Uptake and continuation rates of the intrauterine system in a university student general practice population in the UK. J Fam Plann Reprod Health Care 39(3):186–189.
OpenUrl Abstract/FREE Full Text
2.↵
1. National Institute for Health and Clinical Excellence
(2005) Long-acting reversible contraception. CG30 (NICE, London) http://nice.org.uk/nicemedia/live/10974/29912/29912.pdf (accessed 5 Aug 2013).
3.↵
1. Draper IB,
2. Haque MS,
3. McManus RJ
(2012) Routine intrauterine device checks: are they advisable? J Fam Plann Reprod Health Care 38(1):15–18.
OpenUrl Abstract/FREE Full Text
4.↵
1. Middleton AJ,
2. Naish J,
3. Singer N
(2011) General practitioners’ views on the use of the levonorgestrel-releasing intrauterine system in young nulligravid women, in London. Eur J Contracep Reprod Health Care 16(4):311–318.
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