What you should know about Long Acting Reversible Contraceptives or IUDs
October 17, 2014
Does it seem that more of your friends are using IUDs or contraceptive implants? IUDs, intrauterine devices, and contraceptive implants are becoming more popular in the United States. In this post, we will discuss these birth control methods and why they are gaining in popularity.
What are IUDs?
IUDs are plastic devices that are placed in the uterus by a healthcare provider. There are three products available in the U.S.:
The copper IUD (ParaGard) has the addition of copper wire wound around the stem of the T shaped device which interferes with sperm transport and prevents fertilization. This has been available since 1989 and is effective for 10 years. In addition, the copper IUD can be used as emergency birth control if placed within five days of unprotected sex.
The progestin containing IUDs (Mirena and Skyla) contain levonorgestrel and they prevent fertilization. They interfere with sperm migration, change the uterine lining and make cervical mucus thicker so sperm are less able to pass through to the uterus. Mirena was approved in 2000 for five years of effectiveness. It is also FDA approved to control heavy uterine bleeding. Skyla, which is smaller and contains less hormone, was approved in 2013 and is effective for three years.
- Contraceptive implants are four centimeter long rods that contain a hormone that inhibits ovulation in most cycles and causes changes in the uterine lining and cervical mucus. A single rod is placed under the skin of the upper arm by a trained healthcare provider. It is effective for three years and was known as Implanon from 2006 to 2012 and is now available as Nexplanon.
More about Long Acting Reversible Contraceptives (LARCs)
All LARC methods are generally very convenient and effective. This is from the fact that once placed there is little a woman needs to do to maintain her birth control effectiveness. This is unlike many other types of birth control that need more regular attention, such as taking a pill every day. This leads to high continuation rates, high satisfaction and low failure rates.
All of these methods have advantages, disadvantages, potential risks and side effects. Limited information is offered here, so having a complete discussion with your health provider is very important before making a decision. None of these birth control approaches offers protection against sexual infections, so condom use is encouraged too.
These Long Acting Reversible Contraceptives (LARCs) are gaining in popularity. In 2009, 8.5% of women using birth control were using LARCs, which was up from 5.5% in 2007 and 2.4% in 2002. Foreign born women are three times as likely to use IUDs as U.S. born women.
A program in Colorado offered low income teens LARCs at no cost and there was a 40% drop in birthrate over four years. A study in the St. Louis area offered free birth control services and many of the teens selected LARCs; there was a 41 % reduction in the pregnancy rate.
The length of time from beginning intercourse to the time a first pregnancy is desired is getting longer for many women. Professional groups, including the American Congress of Obstetricians and Gynecologists and more recently in September 2014, The American Academy of Pediatrics, have suggested that LARCs be first line birth control in adolescents and in women who have never had children. Why are LARCs getting more popular?
More providers are offering LARCs to more women. Barriers to use such as lack of knowledge and lack of access are being reduced. Cost is a barrier for many women, but that is improving with more people having contraceptive coverage with their health plans and that helps reduce the high upfront costs.
Is a LARC in your future? You may want to consider one of these methods if you desire a long acting reversible birth control method that is convenient and effective. Please talk with your health provider about what is best for you.