The Levonorgestrel Intrauterine System: A Pragmatic View of an Excellent Contraceptive

In this issue of Global Health: Science and Practice, Hubacher makes a good case for the levonorgestrel intrauterine system (LNG IUS) and why donors should purchase it for provision in African family planning programs.1 The LNG IUS is indeed an excellent contraceptive. It is highly effective, with only 2 pregnancies per 1,000 women in 1 year of typical use,2 a level of effectiveness 4 times that of the copper-containing IUD, and 35 and 70 times that of the injectable and pill, respectively. The LNG IUS also has very high satisfaction and continuation rates, and it confers important non-contraceptive—even therapeutic—benefits. And, like other long-acting reversible contraceptives (LARCs), it is suitable for all reproductive intentions (delaying, spacing, or limiting births). Both the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics have endorsed LARCs as “first-line” method choices for adolescents and young women.