From the Guidelines
Both IUDs and Nexplanon are highly effective forms of long-acting reversible contraception, with effectiveness rates over 99%, and the choice between them should be based on individual factors, but Nexplanon (etonogestrel implant) is slightly more effective with a failure rate of less than 0.1%. According to the most recent evidence 1, Nexplanon has a failure rate of less than 0.1%, making it the most effective reversible contraception available. Hormonal IUDs like Mirena, Kyleena, Liletta, and Skyla have failure rates of about 0.1-0.4%, while the copper IUD (Paragard) has a failure rate of about 0.8%.
Key Differences Between IUDs and Nexplanon
- Nexplanon is a small rod inserted under the skin of the upper arm that lasts for up to 5 years, whereas hormonal IUDs last 3-8 years depending on the brand, and the copper IUD lasts up to 12 years.
- Side effects differ between methods - Nexplanon commonly causes irregular bleeding patterns, while hormonal IUDs typically lead to lighter periods or no periods at all.
- The copper IUD may cause heavier periods initially.
- Nexplanon contains only progestin, making it suitable for those who can't use estrogen.
Considerations for Choosing Between IUDs and Nexplanon
- Desired duration of use
- Hormone sensitivity
- Menstrual preferences
- Medical history
- Both options provide immediate return to fertility upon removal and don't require daily attention like pills, as noted in 1 and 1.
- The American College of Obstetricians and Gynecologists (ACOG) and the CDC both support immediate postpartum insertion of implants as a safe and effective practice that removes barriers to care, as mentioned in 1.
Overall, the decision between IUDs and Nexplanon should be based on individual factors and preferences, with consideration of the most recent evidence 1.
From the Research
Comparative Effectiveness of IUD and Nexplanon
- The comparative effectiveness of Intrauterine Device (IUD) versus Nexplanon (Etonogestrel) can be evaluated based on their contraceptive effectiveness and safety profiles 2, 3, 4, 5, 6.
- Both IUD and Nexplanon are considered long-acting reversible contraceptive (LARC) methods, which are effective options for pregnancy prevention 3, 4, 5, 6.
- IUDs, including copper and levonorgestrel IUDs, have been shown to be highly effective in preventing pregnancy, with failure rates less than 1% 4, 5, 6.
- Nexplanon, an etonogestrel implant, has also been shown to be highly effective, with a failure rate of less than 1% 2, 3, 5.
- The choice between IUD and Nexplanon may depend on individual patient preferences and medical history, as well as the potential for side effects and complications 2, 3, 4, 5, 6.
- Extended use of both IUD and Nexplanon beyond their approved duration of use may be a safe and effective option for many patients 5.
- Clinicians should discuss the effectiveness and potential risks of each method with patients to allow them to make informed decisions about their contraceptive options 3, 5, 6.