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Commentary on: Diedrich JT, Klein DA, Peipert JF, et al. Long-acting reversible contraception in adolescents: a systematic review and meta-analysis. Am J Obstet Gynecol. 2017;216:364.e1-364.e12.
Long-acting reversible contraception (LARC) consists of intrauterine devices and subdermal implants. LARC is in the highest tier of effectiveness and once started, most women tend to be satisfied and use it for long durations. Historically, LARC use has been concentrated in older, higher parity populations. Dissatisfaction or weariness with shorter-term contraceptives often leads women to try LARC; in addition, LARC retention (continued use) may be linked to stage of life and more resolute, long-term intentions. Thus, most of what we know about LARC effectiveness is biased by self-selection, user characteristics and needs.
Women aged 15–19 are not typical LARC users; among those on contraception, 4% use LARC.1 Difficult-to-use, short-term products are the mainstay and it …
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