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Long Active Reversible Contraceptives

Choosing the right birth control can seem like a daunting task. Here is a brief guide to one type of birth control known as Long Acting Reversible Contraceptives.

Long Active Reversible Contraceptives

Choosing the right birth control can seem like a daunting task, especially with dozens of types to choose from.  Finding the method of birth control that is right for you can be influenced by a number of different factors including the effectiveness of the method, any related costs, how invasive it is, the complexity of the method, and  your religious or philosophical beliefs.  Here is a brief guide to one type of birth control known as Long Acting Reversible Contraceptives.

Long Acting Reversible Contraceptives(LARCs) are highly effective methods of birth control that last for an extended period of time without requiring any user interaction. These include both hormonal and non hormonal IUDs(intrauterine devices), subdermal implants and injections.  One of the great advantages of LARCs is they are low maintenance and are effective for months or years before you have to go back to the doctor.  The fact they are so long lasting is also one of the reasons they are so effective.  They are also easily reversible if you decide later in life you would like to become pregnant. The least pleasant thing about LARCs is that they would require a mildly invasive procedure to implant or inject the device.  Here is a brief description of the different types of LARCs available:

  • Subdermal implant; Nexplanon  The Nexplanon injection is a thin plastic implant about the size of a matchstick that is inserted under the skin of the upper arm and only needs to be replaced once every three years.  It works by releasing the hormone progestin which prevents eggs from leaving the ovaries and thickens the mucus of the cervix making it hard for sperm to reach the egg, therefore preventing pregnancy.  The implant becomes effective one week after insertion unless it is inserted on the first day of your period, in which case it becomes effective immediately.  Less than 1 out of 100 women a year become pregnant while using the implant, making it one of the most effective forms of birth control available.  Common side effects include irregular period, increased bleeding during periods, spotting, or absence of period.  Less common side effects include mild weight gain, sore breasts, nausea, headache, or pain at the injection site.
  • IUDs; Mirena, Paragard, Skyla- An IUD is a "T" shaped device inserted into the uterus to prevent pregnancy.  The Mirena and Skyla IUD are hormonal IUDs that release progestin.  The Skyla IUD is effective for three years and the Mirena is effective for five years.  They prevent pregnancy the same way as the subdermal implants and also become effective one week after insertion unless they are inserted on the first day of your period, in which case they become effective immediately.  The Paragard IUD has copper in it but no hormones.  It becomes effective immediately upon insertion and can last 10-12 years.  It works to prevent pregnancy by preventing the sperm from meeting the egg and making it difficult for the egg to attach to the uterus.  The Paragard IUD can also be used as an emergency contraceptive if it is inserted within 120 hours of having unprotected sex.  Less than 1 out of 100 women a year become pregnant while using a Mirena or Skyla IUD, making them almost as effective as Nexplanon.  The Paragard IUD is only slightly less effective with 1 out of 100 women becoming pregnant during the first year of use.
  • Depo-Provera shot- The Depo-Provera shot is a hormonal injection of the hormone progestin and works to prevent pregnancy the same way as the subdermal  implants and Mirena IUD.  The Depo-Provera shot must be administered every twelve weeks.  As long as it is administered regularly, the Depo-Provera shot is just as effective at preventing pregnancy as the other LARCs, but in practical use, not all women continue to get the shot regularly.  As a result, between 1 and 6 women out of 100 will become pregnant in the first year of using the Depo-Provera shot.  The Depo-Provera shot becomes effective one week after injection unless it is injected on the first day of your period, in which case it becomes effective immediately.

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