New Options in Contraception
DOI:
https://doi.org/10.58931/cwht.2024.118Abstract
In the last few years, more contraceptive options have been introduced into Canada, expanding choice for our patients. Patients and clinicians have experienced changes in how health care is accessed and delivered. For patients, this includes an increased use of the internet and social media as sources of information. Also included are changes to insurance coverage for contraception, such as provincial coverage for some (British Columbia, Quebec and Manitoba), and private insurance offered through school or an employer. In 2015 the cost of universal coverage of contraception in Canada was $157 million, while the cost to provide health care for unintended pregnancies was $320 million, providing a strong economic argument for this change. For clinicians, the pandemic provided an opportunity for many to switch to increase the use of virtual care options, and toward efficiencies in practice.
References
Black AY, Guilbert E, Hassan F, Chatziheofilou I, Lowin J, Jeddi M, et al. The cost of unintended pregnancies in Canada: estimating direct cost, role of imperfect adherence, and the potential impact of increased use of long-acting reversible contraceptives. J Obstet Gynaecol Can. 2015;37(12):1086-1097. doi: 10.1016/s1701-2163(16)30074-3
Ping TY, Kautsar H, Kennedy CE, Gaffield ME. Values and preferences for contraception: a global systematic review. Contraception. 2022;111:3-21. doi: 10.1016/j.contraception.2022.04.011
Mansour D. International survey to assess women’s attitudes regarding choice of daily versus nondaily female hormonal contraception. Int J Womens Health. 2014;6:367-375. doi: 10.2147/IJWH.S59059
Birgisson NE, Zhao Q, Secura GM, Madden T, Peipert JF. Preventing unintended pregnancy: the Contraceptive CHOICE project in review. J Womens Health. 2015;24(5):349-353. doi: 10.1089/jwh.2015.5191
Shim JY, Ryan ME, Milliren CE, Maslyanskaya S, Borzutzky C, Golub S, et al. Continuation rates of hormonal intrauterine devices in adolescents and young adults when placed for contraceptive and non-contraceptive indications. Contraception. 2024:110304. doi: 10.1016/j.contraception.2023.110304.
Boog K, Cooper C. Long acting reversible contraception. Obstetrics, Gynaecology and Reproductive Medicine. 2021;31(7):185-191. https://doi.org/10.1016/j.ogrm.2021.05.002
Secura GM, Madden T, McNicholas C, Mullersman J, Buckel CM, Zhao O, et al. Provision of no-cost, long-acting contraception and teenage pregnancy. N Engl J Med. 2014:371(14):1316-1323. doi: 10.1056/NEJMoa1400506
Benshushan A, Paltiel O, Rojansky N, Brzezinski A, Laufer N. IUD use and the risk of endometrial cancer. Eur J Obstet Gynecol Reprod Biol. 2002;105(2):166-169. https://doi.org/10.1016/S0301-2115(02)00153-7.
Hubacher D, Schreiber CA, Turok DK, Teal SB, Nelson AL. Two different-sized copper IUDS: three-year, single-blind randomized trial to compare discontinuation rates and related endpoints in a nulliparous population. Contraception. 2023;127:110148. https://doi.org/10.1016/j.contraception.2023.110148.
Hauck B, Costescu D. Barriers and misperceptions limiting widespread use of intrauterine contraception among Canadian women. J Obstet Gynaecol Can. 2015;37(7):606-616. doi: 10.1016/S1701-2163(15)30198-5
MIRENA®. Product Monograph. Bayer Inc., Canada. Available from: https://www.bayer.com/sites/default/files/mirena-pm-en.pdf. [Date of Revision 2021 Sept 21, Accessed 2024, Jan 09]
Black A, Costescu D, Guilbert E, Dunn S, Norman WV, Trouton K, et al. Contraception consensus: updated guidance during pandemics and periods of social disruption.[Internet] Ottawa: The Society of Obstetricians and Gynaecologists of Canada 2021. [Published online 2018 Apr 18, Revised and Reaffirmed 2021 Nov 9; Accessed 2024 Jan 09]. Available from: https://sogc.org/common/Uploaded%20files/2020-04%20Contraception%20Consensus%20-%20Final%20Submitted.pdf
Turok DK, Gero A, Simmons RG, Kaiser JE, Stoddard GJ, Sexsmith CD. Levonorgestrel vs. copper intrauterine devices for emergency contraception. N Engl J Med. 2021;384(4):335-344. doi: 10.1056/NEJMoa2022141
MIRENA Product Monograph. https://pdf.hres.ca/dpd_pm/00074627.PDF
Black A, Black D, Toor R, Gersh R, Bhangu P, Costescu D. Hands-on training in a digital world: a novel simulation-based virtual training program for placement and removal of the subdermal contraceptive implant. J Obstet Gynaecol Can. 2022;44(11):1167-1173. https://doi.org/10.1016/j.jogc.2022.08.016
Trouton, K, Why I talk about all long term reversible contraception (LARC). [Internet] Vancouver: UBC-Continuing Professional Development, 2022. [Internet]. [Published online 2022 Sept 12, Cited 2024 Jan 09]. Available from: https://thischangedmypractice.com/all-long-term-reversible-contraception/
Black A, Guilbert E; Co-Authors; Costescu D, Dunn S, Fisher W, et al. Canadian Contraception Consensus (Part 1 of 4). J Obstet Gynaecol Can. 2015;37(10):936-942. doi: 10.1016/s1701-2163(16)30033-0
NEXPLANON®. Product Monograph. Organon, Canada, Inc. Available from: https://www.organon.com/canada-en/wp-content/uploads/sites/5/2021/05/NEXPLANON-PM_E.pdf [Date of Revision 2022 Oct 12, Accessed 2024 Jan 09]
Apter D, Briggs P, Tuppurainen M, Grunert J, Lukkari-Lax E, Rybowski S, et al. A 12-month multicenter, randomized study comparing the levonorgestrel intrauterine system with the etonogestrel subdermal implant. Fertil Steril. 2016;106(1):151-157.e5. doi: 10.1016/j.fertnstert.2016.02.036.
World Health Organization. Medical eligibility criteria for contraceptive use. [Internet] Geneva: World Health Organization; Fifth edition, 2015. [Published online 3 February 2015, Cited 2024 Jan 09]. Available from: https://www.who.int/publications/i/item/9789241549158
Zuniga C, Blanchard K, Harper CC, Wollum A, Key K, Henderson JT. Effectiveness and efficacy rates of progestin-only pills: a comprehensive literature review. Contraception. 2023;119:109925. doi:10.1016/j.contraception.2022.10992
Wollum A, Zuniga C, Blanchard K, Teal S. A commentary on progestin-only pills and the “three-hour window” guidelines: timing of ingestion and mechanisms of action. Contraception. 2023;122:109978. doi:10.1016/j.contraception.2023.109978
Cox HE. The pre-coital use of mini-dosage progestogens. J Reprod Fertil. 1968;Supplement 5:167-172.
Duijkers IJM, Heger-Mahn D, Drouin D, Colli E, Skouby S. Maintenance of ovulation inhibition with a new progestogen-only pill containing drospirenone after scheduled 24-h delays in pill intake. Contraception. 2016;93(4):303-309. doi:10.1016/j.contraception.2015.12.007
Peipert JF, Zhao Q, Allsworth JE, Petrosky E, Madden T, Eisenberg D, et al. Continuation and satisfaction of reversible contraception. Obstet Gynecol. 2011;117(5):1105-1113. doi: 10.1097/AOG.0b013e31821188ad
Gemzell-Danielsson K, Apter D, Zatik J, Weyers S, Piltonen T, Suturina L, et al. Estetrol-Drospirenone combination oral contraceptive: a clinical study of contraceptive efficacy, bleeding pattern and safety in Europe and Russia. BJOC. 2022;29(1):63-71. doi: 10.1111/1471-0528.16840
Giovanni Grandi, Maria Chiara Del Savio, Agnaldo Lopes da Silva-Filho & Fabio Facchinetti (2020) Estetrol (E4): the new estrogenic component of combined oral contraceptives, Expert Review of Clinical Pharmacology, Volume 13, Issue 3, 2020, pp 327-330, DOI: 10.1080/17512433.2020.1750365
Foidart JM, Gemzell-Danielsson K, Kubba A, Douxfils J, Creinin MD, Gaspard U, The benefits of estetrol addition to drospirenone for contraception. AJOG Glob Rep. 2023;3(4):100266. doi:10.1016/j.xagr.2023.100266
Grandi G, Del Savio MC, Lopes da Silva-Filho A, Facchinetti F. Estetrol (E4): the new estrogenic component of combined oral contraceptives. Expert Rev Clin Pharmacol. 2020;13(4):327-330. doi:10.1080/17512433.2020.1750365
