What is the comparative efficacy of subdermal implants versus Copper IUDs as contraceptive methods?

From the Guidelines

Subdermal implants and Copper IUDs are both highly effective contraceptive methods, with failure rates of less than 1% 1. The copper IUD, such as ParaGard, is inserted into the uterus and can remain effective for up to 10 years, while subdermal implants, like Nexplanon or Implanon, release etonogestrel over 3 years.

Key Considerations

• Efficacy: Both methods have a failure rate of less than 1% 1.
• Duration of use: Copper IUDs can last up to 10 years, while subdermal implants are effective for 3 years.
• Potential side effects: Copper IUDs may increase menstrual bleeding, while subdermal implants can cause changes in menstrual bleeding patterns.
• Personal preferences: Women should consider their individual needs and medical history when choosing between these options.

Comparative Efficacy

Both subdermal implants and Copper IUDs are considered highly effective contraceptive methods, with minimal differences in their failure rates 1. The decision between these options should be made in consultation with a healthcare provider, taking into account individual circumstances and priorities.

Additional Factors

• Safety in women with rheumatic and musculoskeletal diseases: Both methods are considered safe for women with these conditions, although copper IUDs may increase menstrual bleeding 1.
• Thrombosis risk: Subdermal implants and Copper IUDs do not increase the risk of thrombosis, making them suitable options for women with a history of thrombosis or at risk of thrombosis 1.

From the Research

Comparative Efficacy of Subdermal Implants versus Copper IUDs

• There are no direct comparisons between subdermal implants and Copper IUDs in the provided evidence.
• However, the efficacy of Copper IUDs is well-documented, with studies showing that they have a very low failure rate, ranging from 0.2-0.5% over 10 years 2.
• Copper IUDs, such as the TCu380A, have been shown to be highly effective in preventing pregnancy, with a failure rate of less than 1 per 100 women in the first year of use 3.
• The efficacy of subdermal implants is not mentioned in the provided evidence, and therefore, a comparative analysis cannot be made.

Safety and Acceptability of Copper IUDs

• Copper IUDs have been shown to be safe and effective, with a low risk of adverse events, including perforation and infection 3.
• The most common reasons for discontinuation of Copper IUDs are menstrual bleeding and dysmenorrhea, but cumulative discontinuation rates are lower than those reported for other methods 3.
• Copper IUDs are highly acceptable to women, with approximately 50% of women continuing to use the method after 5 years 3.

Efficacy of Different Types of IUDs

• Studies have compared the efficacy of different types of IUDs, including copper-containing framed IUDs, and have found that some devices, such as the TCu380A, are more effective than others 4.
• The TCu380A has been shown to be more effective than other IUDs, including the MLCu375 and TCu220, in preventing pregnancy 4.
• However, the provided evidence does not include direct comparisons between subdermal implants and Copper IUDs, and therefore, a comparative analysis of their efficacy cannot be made.