Contraceptive devices for women: Implants, intrauterine devices and other products

Abstract

This chapter focuses on progestogen-only implants and intrauterine devices. These methods have a high effectiveness with pregnancies being rare, however intrauterine devices can be expelled. The inherent safety of both types of device is good. Implants and hormone-releasing intrauterine devices can produce hormonal side effects but also non-contraceptive benefits. The levonorgesetrel intrauterine system is widely used in the treatment of heavy menstrual bleeding. Contraceptive devices often cause changes in menstrual bleeding which may result in discontinuation of the method. There are some risks associated with insertion and removal of implants with scope for their reduction. Perforation of the uterus with intrauterine devices is rare, difficult to prevent but usually relatively straightforward to manage. Return to fertility after all contraceptive devices is rapid. Transdermal patches and vaginal rings are also mentioned in the chapter. While these non-oral routes of combined hormonal contraception administration are considered to be safe, side effects are generally greater than with oral preparations.