Skip to main content

Contraceptive Effectiveness

  • Chapter
The Handbook of Contraception

Part of the book series: Current Clinical Practice ((CCP))

  • 2063 Accesses

Abstract

Contraceptive efficacy describes how well a contraceptive method works with perfect use. Alternatively, contraceptive effectiveness describes how well a method works with typical use. Knowledge of both contraceptive efficacy and effectiveness is important in contraceptive counseling. This chapter reviews the methods with which contraceptive efficacy and effectiveness are determined. Additionally, the best estimates of contraceptive efficacy and effectiveness for each contraceptive method are presented. Finally, this chapter offers general guidelines for contraceptive counseling.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Grady WR, Klepinger DH, Nelson-Wally A. Contraceptive characteristics: the perceptions and priorities of men and women. Fam Plann Perspect. 1999;31(4):168–75.

    Article  CAS  PubMed  Google Scholar 

  2. Trussell J, Hatcher RA, Cates Jr W, Stewart FH, Kost K. A guide to interpreting contraceptive efficacy studies. Obstet Gynecol. 1990;76(3 Pt 2):558–67.

    CAS  PubMed  Google Scholar 

  3. Hatcher RA. Contraceptive technology. 19th ed. New York, NY: Ardent Media; 2008.

    Google Scholar 

  4. Trussell J, Portman D. The creeping Pearl: why has the rate of contraceptive failure increased in clinical trials of combined hormonal contraceptive pills? Contraception. 2013;88(5):604–10.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Potter RG. Application of life table techniques to measurement of contraceptive effectiveness. Demography. 1966;3(2):297–304.

    Article  CAS  PubMed  Google Scholar 

  6. Dominik R, Trussell J, Walsh T. Failure rates among perfect users and during perfect use: a distinction that matters. Contraception. 1999;60(6):315–20.

    Article  CAS  PubMed  Google Scholar 

  7. Tietze C, Poliakoff SR, Rock J. The clinical effectiveness of the rhythm method of contraception. Fertil Steril. 1951;2(5):444–50.

    CAS  PubMed  Google Scholar 

  8. Wilcox AJ, Weinberg CR, O’Connor JF, Baird DD, Schlatterer JP, Canfield RE, et al. Incidence of early loss of pregnancy. N Engl J Med. 1988;319(4):189–94.

    Article  CAS  PubMed  Google Scholar 

  9. Chard T. Pregnancy tests: a review. Hum Reprod. 1992;7(5):701–10.

    CAS  PubMed  Google Scholar 

  10. Johnson SR, Godbert S, Perry P, Parsons P, Roberts L, Buchanan P, et al. Accuracy of a home-based device for giving an early estimate of pregnancy duration compared with reference methods. Fertil Steril. 2013;100(6):1635–41.e1.

    Article  PubMed  Google Scholar 

  11. Gerlinger C, Trussell J, Mellinger U, Merz M, Marr J, Bannemerschult R, et al. Different Pearl Indices in studies of hormonal contraceptives in the United States: impact of study population. Contraception. 2014;90(2):142–6.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Frost JJ, Darroch JE. Factors associated with contraceptive choice and inconsistent method use, United States, 2004. Perspect Sex Reprod Health. 2008;40(2):94–104.

    Article  PubMed  Google Scholar 

  13. Westhoff CL, Torgal AT, Mayeda ER, Shimoni N, Stanczyk FZ, Pike MC. Predictors of noncompliance in an oral contraceptive clinical trial. Contraception. 2012;85(5):465–9.

    Article  PubMed  Google Scholar 

  14. Brunner Huber LR, Toth JL. Obesity and oral contraceptive failure: findings from the 2002 National Survey of Family Growth. Am J Epidemiol. 2007;166(11):1306–11.

    Article  PubMed  Google Scholar 

  15. Dinger J, Minh TD, Buttmann N, Bardenheuer K. Effectiveness of oral contraceptive pills in a large U.S. cohort comparing progestogen and regimen. Obstet Gynecol. 2011;117(1):33–40.

    Article  CAS  PubMed  Google Scholar 

  16. Borrero S, Zhao X, Mor MK, Schwarz EB, Good CB, Gellad WF. Adherence to hormonal contraception among women veterans: differences by race/ethnicity and contraceptive supply. Am J Obstet Gynecol. 2013;209(2):103.e1–e11.

    Article  Google Scholar 

  17. Kost K, Singh S, Vaughan B, Trussell J, Bankole A. Estimates of contraceptive failure from the 2002 National Survey of Family Growth. Contraception. 2008;77(1):10–21.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Trussell J. Contraceptive failure in the United States. Contraception. 2011;83(5):397–404.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Sivin I, Stern J. Long-acting, more effective copper T IUDs: a summary of U.S. experience, 1970-75. Stud Fam Plann. 1979;10(10):263–81.

    Article  CAS  PubMed  Google Scholar 

  20. Vessey MP, Wright NH, McPherson K, Wiggins P. Fertility after stopping different methods of contraception. Br Med J. 1978;1(6108):265–7.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Sivin I. International experience with NORPLANT and NORPLANT-2 contraceptives. Stud Fam Plann. 1988;19(2):81–94.

    Article  CAS  PubMed  Google Scholar 

  22. Vaughan B, Trussell J, Kost K, Singh S, Jones R. Discontinuation and resumption of contraceptive use: results from the 2002 National Survey of Family Growth. Contraception. 2008;78(4):271–83.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Peterson HB, Xia Z, Hughes JM, Wilcox LS, Tylor LR, Trussell J. The risk of pregnancy after tubal sterilization: findings from the U.S. Collaborative Review of Sterilization. Am J Obstet Gynecol. 1996;174(4):1161–8. discussion 1168–70.

    Article  CAS  PubMed  Google Scholar 

  24. Peterson HB, Xia Z, Wilcox LS, Tylor LR, Trussell J. Pregnancy after tubal sterilization with bipolar electrocoagulation. U.S. Collaborative Review of Sterilization Working Group. Obstet Gynecol. 1999;94(2):163–7.

    Article  CAS  PubMed  Google Scholar 

  25. Gariepy AM, Creinin MD, Smith KJ, Xu X. Probability of pregnancy after sterilization: a comparison of hysteroscopic versus laparoscopic sterilization. Contraception. 2014;90(2):174–81.

    Article  PubMed  Google Scholar 

  26. Jamieson DJ, Costello C, Trussell J, Hillis SD, Marchbanks PA, Peterson HB, et al. The risk of pregnancy after vasectomy. Obstet Gynecol. 2004;103(5 Pt 1):848–50.

    Article  PubMed  Google Scholar 

  27. Cook LA, Van Vliet HA, Lopez LM, Pun A, Gallo MF. Vasectomy occlusion techniques for male sterilization. Cochrane Database Syst Rev. 2014;3. CD003991.

    Google Scholar 

  28. Sivin I, Alvarez F, Diaz J, Diaz S, el Mahgoub S, Coutinho E, et al. Intrauterine contraception with copper and with levonorgestrel: a randomized study of the TCu 380Ag and levonorgestrel 20 mcg/day devices. Contraception. 1984;30(5):443–56.

    Article  CAS  PubMed  Google Scholar 

  29. Wu JP, Pickle S. Extended use of the intrauterine device: a literature review and recommendations for clinical practice. Contraception. 2014;89(6):495–503.

    Article  PubMed  Google Scholar 

  30. Wu S, Hu J, Wildemeersch D. Performance of the frameless GyneFix and the TCu380A IUDs in a 3-year multicenter, randomized, comparative trial in parous women. Contraception. 2000;61(2):91–8.

    Article  CAS  PubMed  Google Scholar 

  31. Tietze C, Lewit S. The IUD and the pill: extended use-effectiveness. Fam Plann Perspect. 1971;3(2):53–5.

    Article  CAS  PubMed  Google Scholar 

  32. Cox M, Tripp J, Blacksell S. Clinical performance of the levonorgestrel intrauterine system in routine use by the UK Family Planning and Reproductive Health Research Network: 5-year report. J Fam Plann Reprod Health Care. 2002;28(2):73–7.

    Article  PubMed  Google Scholar 

  33. Diaz J, Bahamondes L, Monteiro I, Petta C, Hildalgo MM, Arce XE. Acceptability and performance of the levonorgestrel-releasing intrauterine system (Mirena) in Campinas, Brazil. Contraception. 2000;62(2):59–61.

    Article  CAS  PubMed  Google Scholar 

  34. Backman T, Rauramo I, Huhtala S, Koskenvuo M. Pregnancy during the use of levonorgestrel intrauterine system. Am J Obstet Gynecol. 2004;190(1):50–4.

    Article  CAS  PubMed  Google Scholar 

  35. Ronnerdag M, Odlind V. Health effects of long-term use of the intrauterine levonorgestrel-releasing system. A follow-up study over 12 years of continuous use. Acta Obstet Gynecol Scand. 1999;78(8):716–21.

    Article  CAS  PubMed  Google Scholar 

  36. Croxatto HB, Urbancsek J, Massai R, Coelingh Bennink H, van Beek A. A multicentre efficacy and safety study of the single contraceptive implant Implanon. Implanon Study Group. Hum Reprod. 1999;14(4):976–81.

    Article  CAS  PubMed  Google Scholar 

  37. Zheng SR, Zheng HM, Qian SZ, Sang GW, Kaper RF. A randomized multicenter study comparing the efficacy and bleeding pattern of a single-rod (Implanon) and a six-capsule (Norplant) hormonal contraceptive implant. Contraception. 1999;60(1):1–8.

    Article  CAS  PubMed  Google Scholar 

  38. Xu H, Wade JA, Peipert JF, Zhao Q, Madden T, Secura GM. Contraceptive failure rates of etonogestrel subdermal implants in overweight and obese women. Obstet Gynecol. 2012;120(1):21–6.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  39. Darney P, Patel A, Rosen K, Shapiro LS, Kaunitz AM. Safety and efficacy of a single-rod etonogestrel implant (Implanon): results from 11 international clinical trials. Fertil Steril. 2009;91(5):1646–53.

    Article  PubMed  Google Scholar 

  40. Westhoff C. Depot-medroxyprogesterone acetate injection (Depo-Provera): a highly effective contraceptive option with proven long-term safety. Contraception. 2003;68(2):75–87.

    Article  CAS  PubMed  Google Scholar 

  41. Kaunitz AM, Darney PD, Ross D, Wolter KD, Speroff L. Subcutaneous DMPA vs. intramuscular DMPA: a 2-year randomized study of contraceptive efficacy and bone mineral density. Contraception. 2009;80(1):7–17.

    Article  CAS  PubMed  Google Scholar 

  42. Fu H, Darroch JE, Haas T, Ranjit N. Contraceptive failure rates: new estimates from the 1995 National Survey of Family Growth. Fam Plann Perspect. 1999;31(2):56–63.

    Article  CAS  PubMed  Google Scholar 

  43. Postlethwaite DL. Evaluation of an oral contraceptive containing only progestogen. Practitioner. 1976;217(1299):439–43.

    CAS  PubMed  Google Scholar 

  44. Dieben TO, Roumen FJ, Apter D. Efficacy, cycle control, and user acceptability of a novel combined contraceptive vaginal ring. Obstet Gynecol. 2002;100(3):585–93.

    Article  CAS  PubMed  Google Scholar 

  45. Audet MC, Moreau M, Koltun WD, Waldbaum AS, Shangold G, Fisher AC, et al. Evaluation of contraceptive efficacy and cycle control of a transdermal contraceptive patch vs an oral contraceptive: a randomized controlled trial. JAMA. 2001;285(18):2347–54.

    Article  CAS  PubMed  Google Scholar 

  46. Archer DF, Cullins V, Creasy GW, Fisher AC. The impact of improved compliance with a weekly contraceptive transdermal system (Ortho Evra) on contraceptive efficacy. Contraception. 2004;69(3):189–95.

    Article  CAS  PubMed  Google Scholar 

  47. Walsh TL, Frezieres RG, Peacock K, Nelson AL, Clark VA, Bernstein L, et al. Effectiveness of the male latex condom: combined results for three popular condom brands used as controls in randomized clinical trials. Contraception. 2004;70(5):407–13.

    Article  PubMed  Google Scholar 

  48. Frezieres RG, Walsh TL, Nelson AL, Clark VA, Coulson AH. Evaluation of the efficacy of a polyurethane condom: results from a randomized, controlled clinical trial. Fam Plann Perspect. 1999;31(2):81–7.

    Article  CAS  PubMed  Google Scholar 

  49. Steiner MJ, Dominik R, Rountree RW, Nanda K, Dorflinger LJ. Contraceptive effectiveness of a polyurethane condom and a latex condom: a randomized controlled trial. Obstet Gynecol. 2003;101(3):539–47.

    Article  CAS  PubMed  Google Scholar 

  50. Walsh TL, Frezieres RG, Peacock K, Nelson AL, Clark VA, Bernstein L. Evaluation of the efficacy of a nonlatex condom: results from a randomized, controlled clinical trial. Perspect Sex Reprod Health. 2003;35(2):79–86.

    PubMed  Google Scholar 

  51. Trussell J, Strickler J, Vaughan B. Contraceptive efficacy of the diaphragm, the sponge and the cervical cap. Fam Plann Perspect. 1993;25(3):100–5. 135.

    Article  CAS  PubMed  Google Scholar 

  52. Raymond EG, Chen PL, Luoto J, Spermicide Trial Group. Contraceptive effectiveness and safety of five nonoxynol-9 spermicides: a randomized trial. Obstet Gynecol. 2004;103(3):430–9.

    Article  CAS  PubMed  Google Scholar 

  53. Raymond EG, Trussell J, Weaver MA, Reeves MF. Estimating contraceptive efficacy: the case of spermicides. Contraception. 2013;87(2):134–7.

    Article  PubMed  Google Scholar 

  54. Arevalo M, Jennings V, Sinai I. Efficacy of a new method of family planning: the Standard Days Method. Contraception. 2002;65(5):333–8.

    Article  PubMed  Google Scholar 

  55. Arevalo M, Jennings V, Nikula M, Sinai I. Efficacy of the new TwoDay method of family planning. Fertil Steril. 2004;82(4):885–92.

    Article  PubMed  Google Scholar 

  56. Frank-Herrmann P, Heil J, Gnoth C, Toledo E, Baur S, Pyper C, et al. The effectiveness of a fertility awareness based method to avoid pregnancy in relation to a couple’s sexual behaviour during the fertile time: a prospective longitudinal study. Hum Reprod. 2007;22(5):1310–9.

    Article  CAS  PubMed  Google Scholar 

  57. Trussell J, Grummer-Strawn L. Contraceptive failure of the ovulation method of periodic abstinence. Fam Plann Perspect. 1990;22(2):65–75.

    Article  CAS  PubMed  Google Scholar 

  58. Dude A, Neustadt A, Martins S, Gilliam M. Use of withdrawal and unintended pregnancy among females 15-24 years of age. Obstet Gynecol. 2013;122(3):595–600.

    Article  PubMed  Google Scholar 

  59. Harper CC, Blum M, de Bocanegra HT, Darney PD, Speidel JJ, Policar M, et al. Challenges in translating evidence to practice: the provision of intrauterine contraception. Obstet Gynecol. 2008;111(6):1359–69.

    Article  PubMed  Google Scholar 

  60. Akers AY, Gold MA, Borrero S, Santucci A, Schwarz EB. Providers’ perspectives on challenges to contraceptive counseling in primary care settings. J Womens Health (Larchmt). 2010;19(6):1163–70.

    Article  Google Scholar 

  61. Dehlendorf C, Ruskin R, Darney P, Vittinghoff E, Grumbach K, Steinauer J. The effect of patient gynecologic history on clinician contraceptive counseling. Contraception. 2010;82(3):281–5.

    Article  PubMed Central  PubMed  Google Scholar 

  62. Donnelly KZ, Foster TC, Thompson R. What matters most? The content and concordance of patients’ and providers’ information priorities for contraceptive decision making. Contraception. 2014;90(3):280–7.

    Article  PubMed  Google Scholar 

  63. Eisenberg DL, Secura GM, Madden TE, Allsworth JE, Zhao Q, Peipert JF. Knowledge of contraceptive effectiveness. Am J Obstet Gynecol. 2012;206(6):479.e1–e9.

    Article  Google Scholar 

  64. Steiner MJ, Trussell J, Mehta N, Condon S, Subramaniam S, Bourne D. Communicating contraceptive effectiveness: a randomized controlled trial to inform a World Health Organization family planning handbook. Am J Obstet Gynecol. 2006;195(1):85–91.

    Article  PubMed  Google Scholar 

  65. Lopez LM, Steiner M, Grimes DA, Hilgenberg D, Schulz KF. Strategies for communicating contraceptive effectiveness. Cochrane Database Syst Rev. 2013;4. CD006964.

    Google Scholar 

  66. Hodgson EJ, Collier C, Hayes L, Curry LA, Fraenkel L. Family planning and contraceptive decision-making by economically disadvantaged, African-American women. Contraception. 2013;88(2):289–96.

    Article  PubMed Central  PubMed  Google Scholar 

  67. Daley AM. What influences adolescents’ contraceptive decision-making? A meta-ethnography. J Pediatr Nurs. 2014;29(6):614–32.

    Article  PubMed  Google Scholar 

  68. Yee L, Simon M. The role of the social network in contraceptive decision-making among young, African American and Latina women. J Adolesc Health. 2010;47(4):374–80.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Crystal Goldsmith MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Goldsmith, C. (2016). Contraceptive Effectiveness. In: Shoupe, D., Mishell, Jr., D. (eds) The Handbook of Contraception. Current Clinical Practice. Humana Press, Cham. https://doi.org/10.1007/978-3-319-20185-6_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-20185-6_1

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-20184-9

  • Online ISBN: 978-3-319-20185-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics