TY - JOUR T1 - Extended Effectiveness of the Etonogestrel-Releasing Contraceptive Implant and the 20 µg Levonorgestrel-Releasing Intrauterine System for 2 Years Beyond U.S. Food and Drug Administration Product Labeling JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT SP - 534 LP - 539 DO - 10.9745/GHSP-D-17-00296 VL - 5 IS - 4 AU - Moazzam Ali AU - Luis Bahamondes AU - Sihem Bent Landoulsi Y1 - 2017/12/28 UR - http://www.ghspjournal.org/content/5/4/534.abstract N2 - Recently published evidence from 2 large studies find that the duration of effectiveness of the etonorgestrel-releasing contraceptive implant to be at least 5 years (compared with the current 3-year label), and for the 20 µg levonorgestrel-releasing intrauterine system at least 7 years (compared with the current 5-year label).Contraceptive implants, the levonorgestrel-releasing intrauterine system (LNG IUS), and the copper-bearing intrauterine device (IUD) are long-acting reversible contraceptives (LARCs) with high contraceptive effectiveness. The cumulative pregnancy rates in the first 3 years of use of LARCs is 0.9 per 100 woman-years.1 In comparison, the percentages of women experiencing an unintended pregnancy during the first year of typical use of short-acting methods are much higher, including for male condoms (18%), the diaphragm (18%), Depo-Provera injectables (6%), and combined oral contraceptive pills or progestin-only pills (9%).2The high effectiveness of LARCs is equal in women of all ages, whereas younger women using the pill, patch, or vaginal ring have a significant increase in contraceptive failure in comparison with failure rates among older women.3 Moreover, LARCs convey many other advantages for clients in terms of convenience, satisfaction, ease of continuation, likelihood of avoiding unintended/unwanted pregnancy, and noncontraceptive benefits.3–8 For these reasons, LARCs should also be among the readily available contraceptive choices for women, including young and nulliparous women. If their duration of effective use were to be extended, that would likely be another perceived benefit of LARCs.LARCs should be among the readily available contraceptive choices for women.Etonogestrel-Releasing ImplantThe etonogestrel (ENG)-releasing implant contains 68 mg ENG embedded in 1 ethylene-vinyl-acetate rod9 (marketed in the United States as Implanon and Nexplanon, Merck & Co., Inc., Whitehouse Station, NJ, USA). ENG is the biologically active metabolite of desogestrel used in some combined and progestogen-only contraceptive pills. The ENG-releasing implant is … ER -