Highly effective long-acting reversible contraceptives (LARCs), including intrauterine devices (IUDs) and implants, can be an excellent contraceptive choice for women wishing to avoid unplanned pregnancies. However, the method mix of IUDs, including the copper IUD (Cu-IUD) and the 52-mg levonorgestrel intrauterine system (LNG-IUS), is reported to be pitifully small (less than 5%) in 63 countries and only 5%-9% in a further 32 countries. 1 Compared with other contraceptives, LARC methods have lower contraceptive failure, are safe, and have fewer adverse effects. 2 The reported contraceptive failure rate of the TCu380A IUD is 1 per 100 women-years, with up to 12 years of effective protection. 3 For the LNG-IUS, failure is between 0.1 and 0.2 per 100 women-years and 0.3 per 100 womenyears up to the sixth year of use, 4 providing effective contraception for up to 6 years. 5,6
The 52-mg levonorgestrel intrauterine system (LNG-IUS) is one of the most effective contraceptive methods, comparable to that of female permanent contraception. 1 It also has non-contraceptive benefits, such as treating heavy menstrual bleeding, improving anemia, reducing dysmenorrhea and premenstrual symptoms, decreasing the risk of endometrial and ovarian cancer, 2-4 and reducing pain in women with endometriosis and adenomyosis. 5 Despite its contraceptive and non-contraceptive benefits, and the fact that the World Health Organization included the IUS on the list of essential medicines, 6 this device still presents a low prevalence
According to the World Health Organization (WHO), 214 million women in developing countries and low-resource settings want to avoid pregnancy, but do not use a modern contraceptive method. 1 It has been reported 2 that more than 65% of people with unplanned pregnancies in low-and middle-income countries were using traditional contraceptive methods, condoms, or combined oral contraceptives. 2 These methods have low contraceptive efficacy compared to long-acting contraceptive (LARC) methods. 3 The 52 mg levonorgestrel intrauterine system (LNG-IUS) is a highly effective LARC method. 4 However, despite the high contraceptive efficacy, few side effects, rapid return of fertility after removal, high continuation rates, and non-contraceptive benefits, 5,6 its prevalence is still low in many settings. A probable explanation may be the lack of availability in the public sector in many settings,
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