Best birth control methods. Contraceptive implants. 6 (Copy)

Best birth control methods. Contraceptive implants. 6 (Copy)

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Best Birth Control Methods: Why Hormonal Implants and Intrauterine Devices Outperform the Pill

Leading reproductive medicine expert Dr. Philip Darney, MD, in conversation with Dr. Anton Titov, MD, explains why the best birth control methods today are not birth control pills. Instead, long-acting reversible contraception — including hormonal implants and intrauterine devices (IUDs) — offers the highest safety, efficacy, and cost-effectiveness. The discussion highlights how these methods prevent unintended pregnancies, protect women’s health, and are completely reversible, allowing pregnancy as soon as the device is removed. This expert insight helps women make informed choices about safe contraception in the 21st century.

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Why Long-Acting Contraceptives Are Best

According to Dr. Philip Darney, the most effective contraceptives today are long-acting reversible contraceptives (LARCs) — specifically hormonal implants and intrauterine contraceptives. They outperform all other methods, including surgical sterilization, in both efficacy and safety. Their popularity is growing worldwide as women and healthcare providers recognize the advantages of “fit-and-forget” contraception that requires no daily attention.

Limitations and Risks of Birth Control Pills

While oral contraceptive pills have been one of the most popular birth control methods — especially in the United States — they are less effective in practice than IUDs and implants. Pills must be taken daily without fail, and a small proportion of women using them face an increased risk of venous thrombosis, particularly if they have other risk factors. This has been a source of controversy in Western Europe, where the health risks of certain pill formulations have been widely debated.

Advantages of IUDs and Hormonal Implants

Long-acting contraceptives remove much of the “human factor” in pregnancy prevention. Unlike condoms or vaginal methods, they do not require action before each sexual encounter. Unlike pills, they do not require daily compliance. Once inserted, an implant protects against pregnancy for up to five years, and some IUDs last even longer. Both methods are highly reliable due to their mechanisms of action and do not depend on user behavior for continued effectiveness.

Impact on Unplanned Pregnancies and Maternal Health

Globally, 40% to 50% of pregnancies are unintended, including in the United States. Many women with unintended pregnancies experience premature births, which are a leading cause of neonatal mortality. Long-acting contraception significantly reduces the rate of unintended pregnancies, improving both women’s health and infant survival rates. Planned pregnancies are associated with better maternal health outcomes and healthier children.

Cost-Effectiveness of Long-Acting Contraceptives

Although the upfront cost of an IUD or implant may be higher than a month’s supply of birth control pills, the long-term cost is substantially lower. Over several years, these devices are among the cheapest contraception options available when calculated per year of protection. This makes them not only a medical best choice but also an economic one.

Reversibility and Safety of IUDs and Implants

Both IUDs and hormonal implants are completely reversible. Fertility returns quickly after removal, and there is no evidence that IUDs cause pelvic infections or long-term fertility problems. This makes them a safe choice even for teenagers who want reliable contraception now but may wish to have children later in life.

Full Transcript

Best birth control methods are not birth control pills. But “the pill” is still the most popular contraception method. Leading reproductive medicine expert from California talks about the most effective, safe, and cost-effective birth control methods in the 21st century.

Best birth control methods are intrauterine devices and hormonal implants.

Dr. Anton Titov, MD: They are safe and most effective birth control methods.

Dr. Philip Darney, MD: Hormonal implants are best contraception methods because they are very cheap and long-term use. Hormonal implants and intrauterine devices’ action is completely reversible. A woman can become pregnant after removing an intrauterine device. Pregnancy is initiated after removing a hormonal implant.

Dr. Anton Titov, MD: Best birth control methods. As you mentioned earlier, the desired pregnancy is one of the most important indicators for the woman’s health and health for the future child. So access to safe and effective birth control methods is a very important topic in family planning. Oral contraceptives have long been one of the most popular methods of contraception. But you have published extensively on the safety and efficacy of intrauterine devices and implantable contraception. So what are the most effective and safe ways of birth control (contraception) for a woman today?

Dr. Philip Darney, MD: By far the most effective contraceptives are the long-acting highly effective contraceptives you mentioned. They are contraceptive implants and intrauterine contraceptives. They are more effective than surgical sterilization. Because of efficacy and safety, their popularity is increasing all around the world. As you point out, birth control pills have long been the principal method of safe and effective contraception, particularly in the United States. But oral contraceptives are simply not as effective as these long-acting methods. Oral contraceptive pills for a small minority of the women who use them do carry the risk of venous thrombosis (deep venous thrombosis), particularly for women who are already at risk. That’s been a controversial issue in Western Europe. Condoms can be very effective contraceptives, but condoms require effort every time from the couple who is using them. The same is true with any vaginal methods of contraception. So there are real advantages to these long-acting highly effective contraceptives — intrauterine devices and hormonal implants.

Several clinical trials have demonstrated their advantages. Contraceptive implants prevent teenage pregnancy and encourage planned pregnancy. All around the world, 40% to 50% of pregnancies are unintended. This is also true in the United States, but it is not true in Western Europe. Some women who have complications in pregnancy or die as a result of pregnancy — half of them didn’t want to be pregnant in the first place. Those women also have premature births, which is the main cause of neonatal mortality. These women didn’t want to be pregnant in the first place. So helping them to plan pregnancies is a critical determinant of women’s health and infant health.

Dr. Anton Titov, MD: Intrauterine devices and hormonal implants probably remove so much of the human factor — the necessity to remember to take a pill every day or to use condoms every time — that it increases their practical efficacy.

Dr. Philip Darney, MD: Yes. You have a contraceptive implant, it stays there for five years. You don’t need to do anything. You are completely protected from unintended pregnancy. Intrauterine contraceptives last even longer than implants. They are highly effective because of their mechanisms of action. They don’t require you to remember to do anything to use them. You don’t have to remember to take a pill every day. You don’t need to put a condom on every time before intercourse. Intrauterine devices are cheap. The upfront cost may be higher when you have the intrauterine contraceptive inserted, but in the long term they are much cheaper than daily contraception methods.

Dr. Anton Titov, MD: Are the effects of intrauterine contraceptive devices and hormonal implants reversible? How safe are intrauterine devices for fertility?

Dr. Philip Darney, MD: Their action is completely reversible. There’s no evidence that intrauterine contraceptives result in pelvic infections. A woman does not lose her fertility. So we’re happy to provide teenagers who want to avoid a pregnancy with an intrauterine contraceptive if that’s what she’d like to use.

Dr. Anton Titov, MD: Professor Darney, thank you very much for this fascinating and very important conversation. The topic of reproductive health and family planning is most important for women and families around the world. I’m very grateful for the opportunity to speak with you today. Thank you!

Dr. Philip Darney, MD: It’s been my pleasure. Thanks for your good questions.

Dr. Anton Titov, MD: Best birth control methods — hormonal implants, intrauterine contraceptive devices — safety and efficacy. How to choose the best and safest contraception method?