Let’s Talk Birth Control: Part One

Mar 02, 2021

Let’s Talk Birth Control: Part One

Did you know that if you are sexually active and not using birth control, you’re about 85% likely to become pregnant within a year? Choosing the right birth control method can be overwhelming but it is important to be familiar with all of your options. One popular form of birth control is long-acting reversible contraception (LARC).

What is long-acting reversible contraception (LARC)?

LARCs are the most effective, reversible birth control. They’re safe and effective for most women and teens and can be removed at any time if your plans change. Insertion of LARC is done in-office and provides worry-free contraception for 3-10 years depending on the method you choose.

What types of LARC are there?

● Intrauterine device (IUD): a small, T-shaped device that your healthcare provider inserts into your uterus to prevent pregnancy.

● Arm implant: a thin, matchstick-sized plastic rod that your healthcare provider inserts under the skin of your upper arm to prevent pregnancy.

What are my IUD options?

There are several IUDs to choose from. There are hormone (progestin)-containing IUDs and one type of hormone-free (copper) IUD.

Progestin-containing IUDs

Hormonal IUDs contain a type of progestin called levonorgestrel. This is the same type of hormone that is used in many birth control pills, however very little of the hormone actually enters your bloodstream. These IUDs do not contain estrogen. Hormonal IUDs are over 99% effective and work in several ways to prevent pregnancy including: thickening cervical mucus, inhibiting sperm movement, reducing sperm survival, and thinning the lining of the uterus. Because the hormone thins the lining of your uterus, your periods will become lighter and often go away all together. (Results may vary based on which IUD you choose). IUDs can be used in women who’ve had babies and women who have never been pregnant.

There are four different progestin containing IUDs:

• Liletta contains 52 mg of levonorgestrel and is currently approved for 6 years of use.
• Mirena contains 52 mg of levonorgestrel and is currently approved for 6 years of use.
• Kyleena contains 19.5 mg of levonorgestrel and is currently approved for 5 years of use.
• Skyla contains 13.5 mg of levonorgestrel and is currently approved for 3 years of use.

What are side effects of progestin-containing IUDs?

The progestin IUDs are generally very well tolerated because of the way the hormone is absorbed. Bleeding and spotting may increase for the first 3-6 months after your IUD is inserted. After that time period, periods become lighter and often go away altogether. Some other possible side effects include: headaches, nausea, breast tenderness, mood changes, and ovarian cyst formation.

Who should not use a progestin-containing IUD?

You should not use a hormonal IUD if you are or might be pregnant, have a serious pelvic infection called pelvic inflammatory disease (PID), have an untreated lower genital infection, have had an infection from an abortion within the last 3 months, have abnormal vaginal bleeding that cannot be explained, have liver disease or a liver tumor, have breast, uterine, or cervical cancer, or get infections easily.

Hormone Free (Copper) IUD

There is one hormone-free IUD available in the US called Paragard. It is 100% hormone free and 99% effective at preventing pregnancy for up to ten years. Paragard works by preventing sperm from reaching and fertilizing the egg. It may also prevent implantation.

What are side effects of Paragard?

The Paragard IUD does not have hormones, so there are few side effects associated with the device. Your period may become heavier, longer, and you may have spotting between periods. You may also experience an increase in cramping.

Who should not use Paragard?

You should not use Paragard if you have a pelvic infection, certain cancers, a copper allergy, Wilson’s disease, or PID(Pelvic Inflammatory Disease).

Can I use Paragard for Emergency Contraception?

Yes. The Paragard IUD lowers your chances of getting pregnant by more than 99.9 percent if you have it inserted within 5 days of unprotected sex. It’s the most effective kind of emergency contraception there is.

Arm Implant

Nexplanon is a small arm implant that provides up to 3 years of pregnancy prevention and is over 99% effective. It is inserted by your provider superficially under the skin of your upper, inner arm. Nexplanon slowly releases a low dose of one type of progesterone called etonogestrel, to prevent an egg from being released by your ovary (ovulation) and to prevent sperm from reaching the egg. It also thins the lining of your uterus.

What are the side effects of Nexplanon?

The most common side effect of Nexplanon is a change in your menstrual bleeding pattern. This means your period could go away altogether or you could have frequent, heavier, or irregular periods. Other side effects of Nexplanon include: mood swings, weight gain, headache, acne, and depressed mood. If you have anxiety or depression, you should ask your healthcare provider if Nexplanon is right for you.

Who should not use Nexplanon?

You should not use Nexplanon if you are pregnant or think you may be pregnant; have or have had blood clots; have liver disease or a liver tumor; have unexplained vaginal bleeding; have breast cancer or any other cancer that is sensitive to progestin (a female hormone), now or in the past; or are allergic to anything in Nexplanon.

Do LARC’s protect me from STD?

No! Condoms are the only form of birth control that also protect against sexually transmitted infection.

I know my options and I am interested in LARC, now what?

Make an appointment with your healthcare provider to make sure LARC is right for you! There are usually additional steps, like talking to your insurance, that need to be done before a device can be inserted.

Written by Emily Miller-Dawson, NP:

Emily is a Colorado native and joined Red Rocks OB/GYN (a member of OB/GYN Affiliates) in July of 2020. She began her medical career as a CNA in 2010 and worked with post-operative spine patients. She earned her undergraduate degree from Denver College of Nursing in 2013 and transitioned into a nursing role in the Emergency Department at Swedish Medical Center, where she spent the majority of her nursing career. She then earned her Master's degree at Walden University and became a board-certified Family Nurse Practitioner. Emily is passionate about supporting women and enjoys being part of their preventive health and obstetrical care. She has participated in multiple medical mission trips to Haiti and Cambodia. Emily enjoys spending time with her husband and fur babies. She loves travel, champagne, plants, and live music.  Schedule an appointment with Emily by visiting http://www.redrocksobgyn.com/