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Long-acting reversible contraceptives

Why more women are choosing long-acting reversible contraceptives

More American women are opting to use long-acting reversible contraceptives (LARCs), like intrauterine devices (IUDs) and hormonal implants, as their primary source of birth control.

A study conducted by the Centers for Disease Control and Prevention (CDC) found that the use of LARCs is nearly five times higher than it was in the last decade among women between the ages of 15 to 44.

And although birth control pills are still the most popular contraceptive method, LARCs are the fastest-growing form of birth control.

“LARCs are amazing,” says Tia Guster, M.D., an obstetrician and gynecologist at Piedmont. “As far as their efficacy, they are equivalent to permanent sterilization, except they are reversible. So if you change your mind, you just take it out. And fertility returns pretty quickly.”

There are two types of LARCs:  intrauterine devices (IUDs) and subdermal hormonal implants.

What are IUDs?

IUDs are flexible, medicated, “T-shaped” devices that are inserted through the cervix and into the uterus to prevent pregnancy. Once they are inserted, they are almost 99 percent effective.

There are two types of IUD:

  • The copper IUD:  The ParaGard IUD can prevent pregnancy for up to 10 years.
  • Hormonal IUDs: These include Mirena, which prevents pregnancy for up to 5 years; Skyla, which prevents pregnancy for up to 3 years; and Liletta, which also prevents pregnancy for up to 3 years.  

Both the copper and hormonal IUDs prevent pregancy by changing the uterine environment to decrease the chances of egg fertilization and implantation.

How are IUDs inserted?

“The IUD is packaged inside an insertion device that looks like a skinny straw,” explains Dr. Guster.  “The straw is inserted into the cervix. And as it goes through the cervix, the arms deploy or spread out. And it looks like a little “T.”

Dr. Guster says there can be a bit of discomfort when the IUD is inserted, but it doesn’t last long.

“The main thing people experience whenever the cervix is touched or manipulated is a little cramping,” says Dr. Guster.  “I usually tell my patients to take some Tylenol or Motrin before they come in.”

How are IUDs removed?

“Taking it out is so much easier than putting it in,” says Dr. Guster. “The IUDs have little threads tied to the bottom of them that hang outside of the cervix. All we do is tug on the little strings with a medical instrument and the IUD slides out.”

Common side effects of IUDs

The most common side effects of IUDs would be decreased menstruation or having no period at all.

Occasionally, an IUD may slip out. But Dr. Guster says that it happens very rarely. 

“Things that would increase your expulsion rate would be if you had it placed right after having a baby, if you have a tiny uterus, or if you have masses like fibroids,” says Dr. Guster. “But that’s why your provider is supposed to do an exam to measure the size of your uterus.” 

What are subdermal implants?

Subdermal implants, commonly called Nexplanon, are progesterone-based implants inserted under the skin of the arm. They can prevent pregnancy for up to 3 years and are also almost 99 percent effective.

The implant works by releasing the progestin hormone, which suppresses ovulation and thickens cervical mucus-- preventing sperm from getting to the eggs.

Common side effects of the implant include irregular bleeding, decreased menstruation or having no period at all.

Choosing a LARC

More women may be choosing to use LARCs because they are highly effective and easy to use. They can be removed at any time and don’t interfere with sexual intercourse or everyday activities.

“Women are very busy, and that’s what they need: convenience and reliability,” says Dr. Guster. “IUDs and implants totally give you that.”

Need to make an appointment with a Piedmont physician? Save time, book online.


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