Contraceptive Efficacy and Recommendations

Introduction to Contraceptive Options

The American Academy of Pediatrics and CDC recommend counseling patients about the most effective methods first, starting with LARCs (implants and IUDs), which have typical use failure rates of less than 1% 1, 5

Nexplanon (etonogestrel implant) has a 0.05% typical use failure rate, meaning 99.95 out of 100 women will not get pregnant, according to the CDC guidelines 1, 2, 3, 4
Mirena (levonorgestrel IUD) has a 0.2% typical use failure rate, meaning 99.8 out of 100 women will not get pregnant, as recommended by the CDC 1, 2, 3, 4

Long-acting reversible contraceptives (LARCs) like Mirena and Nexplanon are superior because they eliminate user adherence issues, resulting in higher real-world effectiveness 1, 5
NuvaRing (contraceptive ring) has a 9% typical use failure rate, meaning only 91 out of 100 women avoid pregnancy, due to user error and monthly insertion and removal requirements 1, 2, 3, 4
Depo-Provera (DMPA injection) has a 6% typical use failure rate, meaning only 94 out of 100 women avoid pregnancy, due to missed appointments and delayed injections 1, 2, 3, 4

The CDC recommends prioritizing methods with the highest real-world effectiveness, such as LARCs, when counseling patients about contraceptive options 1, 5
Nexplanon has a high continuation rate of 84% at one year and is ideal for patients who cannot use estrogen-containing methods 1, 3, 4
Mirena has a continuation rate of 80% at one year and provides additional benefits, including reduced menstrual bleeding 1, 3, 4