Wellness & Education

Wellness & Education

Long-Acting Reversible Contraception: IUDs and Implants

So far we have discussed hormonal options for birth control, which release estrogen and/or progestin to prevent pregnancy and non-hormonal methods, which physically or chemically prevent sperm from reaching a woman’s egg. Today’s topic is a category that has gained in popularity over recent years: long-acting reversible contraception (LARC).

Long-acting reversible methods of birth control are available in both hormonal and non-hormonal forms. They are an excellent choice for women who have difficulty remembering to take oral birth control and who are at a low risk for sexually transmitted infections. The cost of these methods depends to a great degree on your health insurance coverage. However, all women should consider them when evaluating their options; even thought the initial cost may be higher than other contraception, they prevent pregnancy for between three and 10 years.

Long-Acting Reversible Birth Control OptionsThe Intrauterine Device (IUD)

An IUD is a long-lasting and highly effective method of birth control that comes in both hormonal and non-hormonal versions. Both are t-shaped devices inserted into the uterine cavity by a physician in a simple office procedure. During the first year of use, less than 1 in 100 women using an IUD will become pregnant. Once inserted, this long-acting method of birth control does not interfere with sex or other daily activities, though it serves as no protection against sexually transmitted diseases.

Hormonal IUD: Mirena

The hormonal IUD, available as Mirena, continuously releases small amounts of the hormone levonorgestrel into the uterus. This thickens the cervical mucus and thins the lining of the uterus, which prevent sperm from fertilizing the egg. This hormonal method is effective for up to five years, and it may decrease menstrual pain and heavy menstrual bleeding. Some women may stop menstrual bleeding. 

  • Effectiveness: During the first year of use, less than 1 in 100 women using an IUD will become pregnant. 
  • Other benefits: an IUD can be removed by a trained healthcare provider at any time and requires no action on the part of the user. Like other forms of hormonal birth control, the hormonal IUD may decrease menstrual pain and heavy bleeding. Some women may stop having periods entirely. The hormonal IUD may be used while breastfeeding. 
  • Risks and side effects: Risks and side effects are low, but some women may experience headaches, nausea, or breast tenderness, and others may develop ovarian cysts in their first months of using a hormonal IUD. Though pregnancies while using a hormonal IUD are rare, if they occur they are at an increased risk of being an ectopic pregnancy in which the fetus grows and develops outside of the uterus.

Non-Hormonal IUD: ParaGard 

The non-hormonal IUD, available as ParaGard, is made of plastic wrapped in copper. The device releases small amounts of copper into the uterus, which causes sterile inflammation. These inflammatory cells inhibit the function of the sperm as it passes through. It is also thought to change the lining of the uterus to prevent implantation of a fertilized egg. The non-hormonal IUD is the longest acting method of reversible birth control and can be effective for up to ten years. 

  • Effectiveness: During the first year of use, less than 1 in 100 women using an IUD will become pregnant. 
  • Other benefits: Once inserted, an IUD requires no action on the part of the user. It can be removed by a trained healthcare provider at any time and a woman can begin trying to conceive immediately. The non-hormonal IUD may be used while breastfeeding. 
  • Risks and side effects: In the first months of using a copper IUD, menstrual pain, heavy bleeding and bleeding between periods may increase. Other risks and side effects are similar to the hormonal IUD.

Hormonal Implants: Implanon or Nexplanon 

A hormonal implant is a single rod inserted in the arm under the skin by your healthcare provider. Available as Implanon or Nexplanon, hormonal implants protects against pregnancy for up to three years. Implants release the hormone etonogestrel, which acts in two ways: it helps prevent ovulation and thickens cervical mucus to prevent sperm from reaching the egg. An implant must be removed by your healthcare provider, but you can begin trying to conceive immediately following removal. 

  • Effectiveness: During the first year of use, less than 1 in 100 women with a hormonal implant will become pregnant. 
  • Other benefits: Once inserted, an implant requires no action on the part of the user. It can be removed by a trained healthcare provider at any time and a woman can begin trying to conceive immediately. It can be used by women who are breastfeeding and women who cannot take estrogen. Many women experience fewer and lighter periods after the first six to 12 months of use. 
  • Risks and side effects: Though rare, if a pregnancy occurs, there is a greater risk of it being an ectopic pregnancy. During the first six to 12 months of use, irregular bleeding is the most common side effect.

Do you have questions about contraception? Make an appointment with one of our women’s health nurse practitionersnurse midwives or physiciansContact an office >

Sources: Content - American Congress of Obstetricians; Image - yahoo.com

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