Many currently available birth control methods are effective, but only when they are actually used. A new study shows that methods such as the IUD and hormonal implants, which require no further attention once they are in place, are substantially more effective than methods that require daily attention, such as taking a pill. This story emphasizes the difference in effectiveness without providing much context about how contraceptive decisions are made, which involves weighing effectiveness against other factors such as side effects, cost, and future pregnancy plans.
Preventing unwanted pregnancy is a critical health issue, for women, men, and the society at large, with current estimates of 3 million unplanned pregnancies per year in the U.S., of which half result from failure of birth control methods. Women have many options for birth control, and reliable evidence about the relative effectiveness of each method is an essential factor in making decisions about contraception.
There is no discussion of the costs of long-acting methods (IUDs, implants, and long-acting injections) compared to alternatives such as the birth control pill, patch, or ring, although there is acknowledgement that insurance may not cover long-acting methods. It only briefly addresses IUDs and implants with this line: “can cost patients several hundred dollars if not paid for by insurance.”
The report clearly quantifies the difference in failure rates of the various methods, which range from less than 1% for long-acting methods to about 5% (after 1 year of use) and 9% (after 3 years) for the pill and patch. There is no consideration of other benefits aside from prevention of pregnancy, which can be an important factor in choice of method for some women. For example, the oral contraceptive pill can lessen menstrual cramps, and some IUDs also treat excessively heavy periods.
No mention is made of side effects that may accompany long-acting contraceptive methods, nor of those associated with the birth control pill/patch/ring. While effectiveness in preventing pregnancy is a paramount concern, women also weigh side effects in making a decision about which method to use.
The report notes that the study involved a cohort of 7500 women ages 14 to 45 who were initiating or changing birth control methods and who sought to avoid pregnancy for at least one year.
An independent expert is cited and makes clear that effectiveness, while important, is only one factor in a woman’s decision about a contraceptive method.
The potential for conflict of interest is adequately addressed, noting that one of the researchers is involved in training doctors on how to use one of the implantable methods.
Mixed bag:
The story does a good job of comparing alternatives from the standpoint of effectiveness. However it neglects any consideration of how they compare in terms of side effects and cost.
The higher cost of IUDs and implants can be a significant barrier to availability, as can access to health care providers trained to insert these devices. The story briefly mentions cost issues and lack of insurance coverage for these two options, but it is not clear how often lack of access to care affects availability. We’ll give the story the benefit of the doubt on this criterion.
Older studies have looked retrospectively at the effectiveness of different contraceptive methods, but this study provides a prospective look at how well they work in the real world, among typical users. The novelty is that this study was prospective, allowing more reliable measurement of outcomes such as pregnancy, and that it involved a large, diverse population of U.S. women. The story appropriately referred to the confirmatory nature of the study and how it gives doctors “new ammunition to recommend these (long-lasting) methods.”
The report does not appear to rely on a press release.
Systematic, Criteria-Driven
Puleeeeease... this 'game changer' weight loss drug causes more nausea and vomiting than a placebo. Some game, some change. My friend Gary would spank you for using the eighth word medical reporters should never, ever use. @garyschwitzer @thackerpd
https://www.healthnewsreview.org/toolkit/just-journalists-writing-tips-case-studies/7-words-and-more-you-shouldnt-use-in-medical-news/ https://twitter.com/OttawaCitizen/status/1361426796126830597
A scary @statnews Op-Ed warns that govt attempts to rein in Pharma may cut off access to "life-changing" drugs.
It takes @garyschwitzer to let us know: the author spent 10 years as Pfizer's public-policy chief. https://twitter.com/garyschwitzer/status/1360325022578053123
.@TranspariMED criticizes STAT op-ed for not disclosing pharma funding of author’s institute - similar to criticism we’ve made of STAT op-eds in the past. @transparify @ThinkTankWatch @icer_review https://www.healthnewsreview.org/2021/02/transparency-watchdog-criticizes-stats-non-disclosure-on-pro-pharma-op-ed/
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like