title: Complications and continuation rates associated with 2 types of long-acting contraception.
abstract: OBJECTIVE
  We sought to compare complication and continuation rates of the levonorgestrel intrauterine system (LNG-IUS) with the subdermal etonogestrel (ENG) implant across the United States among girls and women 15-44 years of age.
  
  
  METHODS
  A retrospective study of health insurance claims records from 2007 through 2011 identified a cohort of women who had LNG-IUS (n = 79,920) or ENG implants (n = 7374) inserted and had insurance coverage for 12 months postinsertion. Claims for complications were examined 12 months after insertion, or until removal of either device within each of 3 age groups.
  
  
  RESULTS
  After its introduction in 2007, the frequency of ENG implants increased each year and almost a third of all insertions were in teenagers. However, among women ≤24 years old who had delivered an infant in the prior 8 weeks, a LNG-IUS was more likely to be inserted than an ENG implant (P < .05). The most frequent complications with both methods were related to abnormal menstruation, which was more likely to occur among ENG implant users. Overall, 83-88% of the entire sample used their chosen method for at least 12 months. The odds of continuation were similar for both methods among teenagers, but ENG implants were more likely to be removed prematurely among women 20-24 years old (odds ratio, 1.21; 95% confidence interval, 1.06-1.39) and 25-44 years old (odds ratio, 1.49; 95% confidence interval, 1.35-1.64).
  
  
  CONCLUSIONS
  Both of these long-acting contraceptive methods are well tolerated among women of all ages, and demonstrate high continuation rates.
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX; Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch at Galveston, Galveston, TX. Electronic address: abberens@utmb.edu.
authors.forename: Abbey B
authors.initials: AB
authors.lastname: Berenson
authors.affiliation: Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch at Galveston, Galveston, TX; Institute for Translational Sciences, University of Texas Medical Branch at Galveston, Galveston, TX.
authors.forename: Alai
authors.initials: A
authors.lastname: Tan
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX; Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch at Galveston, Galveston, TX.
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Hirth
mesh_terms: D000293:Adolescent; D000328:Adult; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects; D017135:Desogestrel / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects; D016912:Levonorgestrel / Q000008:administration & dosage / Q000009:adverse effects; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D040521:Subcutaneous Tissue; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; C044815:etonogestrel; D016912:Levonorgestrel; D017135:Desogestrel
keywords: etonogestrel implant; intrauterine device; levonorgestrel intrauterine systems; long-acting reversible contraception