Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, MO, USA.
Drugs. 2011 May 28;71(8):969-80. doi: 10.2165/11591290-000000000-00000.
Long-acting reversible contraception (LARC) includes intrauterine devices (IUDs) and the subdermal implant. These methods are the most effective reversible methods of contraception, and have the additional advantages of being long-lasting, convenient, well liked by users and cost effective. Compared with other user-dependent methods that increase the risk of noncompliance-related method failure, LARC methods can bring 'typical use' failure rates more in line with 'perfect use' failure rates. LARC methods are 'forgettable'; they are not dependent on compliance with a pill-taking regimen, remembering to change a patch or ring, or coming back to the clinician for an injection. LARC method failure rates rival that of tubal sterilization at <1% for IUDs and the subdermal implant. For these reasons, we believe that IUDs and implants should be offered as first-line contraception for most women. This article provides a review of the LARC methods that are currently available in the US, including their effectiveness, advantages, disadvantages and contraindications. Additionally, we dispel myths and misconceptions regarding IUDs, and address the barriers to LARC use.
长效可逆避孕方法（LARC）包括宫内节育器（IUD）和皮下埋植剂。这些方法是最有效的可逆避孕方法，具有长效、方便、使用者满意度高和具有成本效益的额外优点。与其他增加因不遵守规定而导致的方法失败风险的依赖使用者的方法相比，LARC 方法可以带来更符合“完美使用”失败率的“典型使用”失败率。LARC 方法“容易被遗忘”；它们不依赖于遵守服用药物的规定，不依赖于记住更换贴片或环，也不依赖于回到临床医生处注射。IUD 和皮下埋植剂的 LARC 方法失败率与输卵管绝育术的失败率相当，<1%。基于这些原因，我们认为 IUD 和植入物应该作为大多数女性的首选避孕方法。本文综述了目前在美国可用的 LARC 方法，包括它们的有效性、优点、缺点和禁忌症。此外，我们还消除了关于 IUD 的误解和误解，并解决了 LARC 使用的障碍。
