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Contraceptive Pearl: A look at Copper and Progestin IUD Duration

How long do IUDs remain effective? After the FDA approved the progestin (Mirena) and copper (Paragard) IUDs, further studies supported two extra years of use for each device.

The FDA approved the progestin IUD (Mirena) for 5 years of use. In a study conducted at five sites, the progestin IUD remained highly effective up to 7 years after insertion. This study monitored 897 women using the progestin IUD. One hundred and seventy-two women continued use past year five. No pregnancies occurred in year six or seven.

The FDA approved the copper IUD (Paragard) for 10 years of use. According to a 1997 study, the copper IUD remains highly effective up to 12 years after insertion. This multicenter trial enrolled a total of 4,673 women using the copper IUD. The cumulative 12-year failure rate was 2.1-2.8%.

If your patient wants to keep her IUD beyond the FDA-approved limit, evidence supports continuing use for 2 extra years.

The new progestin IUD (Skyla) is FDA approved to protect against pregnancy for 3 years. At this time no studies have researched efficacy beyond this duration.

We appreciate your feedback! Please write to us at pearls@reproductiveaccess.org with any questions, comments or additional resources to add to our list.

 

Helpful Resources

IUD Fact Sheet

Copper IUD User Guide

Progestin IUD User Guide

Patient Assistance Program for Mirena IUD

Patient Assistance Program for Paragard IUD

 

Sources

Sivin I, Stern J, Coutinho E, et al. Prolonged intrauterine contraception: a seven-year randomized study of the levonorgestrel 20 mcg/day (LNg 20) and the Copper T380 Ag IUDs. Contraception. 1991; 44(5):473-480.

Long-term reversible contraception. Twelve years of experience with the TCu380A and TCu220C.Contraception. 1997;56(6):341-52.

Zieman M, Hatcher RA, et al. A Pocket Guide to Managing Contraception. Tiger, Georgia: Bridging the Gap Foundation, 2012.

 

Pharma-free

The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.

Contraceptive Pearls

This monthly clinical e-newsletter highlights evidence-based best practice for contraceptive care

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