Long-Acting Reversible Contraceptives

By Dr. Kristin Algoe, Sandpoint Women's Health   Birth control is defined as any method or practice that prevents pregnancy. Deciding to start a birth control and choosing the right birth control can be very big decisions for a woman. Birth control can help prevent unintended pregnancy but also may help with heavy and/or painful periods and even help prevent certain types of cancers. These days there are a lot of options including long-acting reversible contraceptives (LARCs). These LARCs have many wonderful benefits including their overall effectiveness, easy reversibility and low or no hormone options. Even so, many women have some fears or misconceptions regarding these methods. I would like to teach you a little bit more about what we know about long-acting reversible contraceptives. The LARC methods include the IUDs (intrauterine devices) and the birth control implant. There IUD is a small T-shaped device that your healthcare provider inserts into your uterus during a pelvic exam. This is typically easily done in the office. Most women are great candidates for an IUD and it is a great option for young women and teenagers as well. You do not have to have had already a child to use an IUD. Once it is in place you do not have to do anything else to prevent pregnancy, it is highly effective. There are hormone-releasing IUDs, which release a small amount of progesterone hormone and there are non-hormonal IUDs that contain copper. IUDs are safe for use between 3-10 years depending on which one you choose. The hormone-releasing IUDs have many health benefits including lighter and less painful periods, treatment of endometriosis and prevention of uterine cancer. IUDs work mainly by preventing sperm from fertilizing an egg. Many women have heard stories from friends about complications with the IUD. In truth, complications are very rare and usually happen around the time of insertion. If you wish to stop using an IUD you can have it removed during an office visit. The birth control implant is another long-acting reversible contraceptive. It is a single flexible rod about the size of a matchstick that is inserted under the skin in your upper arm. This is also easily done in the office. The device cannot be seen but it can be felt. Once it is in place you do not have to do anything else to prevent pregnancy, it is also highly effective. The device releases progesterone hormone for up to 3 years. The progesterone dose in this implant is higher and can stop ovulation. The most common side effect is irregular bleeding patterns. Most women are great candidates to use the birth control implant as well. As providers of health care for women, we tend to be big proponents of these LARC methods for several reasons. First, the LARCs are so effective and easy for women to use. In the first year of typical use, less than 1 out of 1000 women will become pregnant. This makes LARCs as effective as having a permanent procedure such as a tubal ligation or a vasectomy, but it is completely reversible! Most providers place these IUDs or implants very frequently and rarely encounter any issues. Second, we like to give our patients birth control options that contain very low doses of hormones or no hormones at all. And last, all of these options are safe with breastfeeding and can be inserted right after a pregnancy. These options do not prevent sexually transmitted infections, so safe sex practices with condoms and regular testing for STDs is very important. In conclusion, I encourage you to consider a long-acting reversible contraception if you are planning to use birth control. There are many benefits and the risks are quite low. Your healthcare provider can always provide you with more information. If you are looking for a good web source for information, I always encourage my patients to visit ACOG.org (American Congress of Obstetricians and Gynecologists).   Sandpoint Women's Health is always accepting new patients. We see patients in Sandpoint and Bonners Ferry. Call 208-263-2173 to make an appointment today or click the button below to request an appointment.