What are long-acting reversible contraception (LARC) methods?
Long-acting reversible contraception (LARC) methods include the intrauterine device (IUD) and the birth control implant. Both methods are highly effective in preventing pregnancy, last for several years, and are easy to use. Both are reversible—if you want to become pregnant or if you want to stop using them, you can have them removed at any time.
What is an IUD?
An intrauterine device (IUD) is a little, t-shaped piece of plastic inserted into the uterus to provide birth control.
The IUD is a small, T-shaped, plastic device that is inserted into and left inside the uterus. There are two types of IUDs:
1. The hormonal IUD releases progestin. Different brands of hormonal IUDs are approved for use for up to 5 years and for up to 3 years.The 3 types of IUDs that use the hormone progestin include Mirena, Skyla, and Liletta. Skyla is the smallest of the progestin IUDs.
2. The copper IUD does not contain hormones. It is approved for use for up to 10 years. The most common brand is Paragard®
Why did I choose Mirena?
Mirena is a hormone-releasing IUD that releases small amounts of a progestin hormone called levonorgestrel locally into the uterus. Mirena lasts for as long as you want, for up to 5 years.
Mirena may be right for you if you are looking for birth control that is:
- Highly Effective—One of the most effective birth control methods—over 99%—and does not rely on you to be effective
- Convenient—No daily pills and no monthly refills. It lasts as long as you want, for up to 5 years. The timeframe is up to you. You should do a monthly self-check to make sure it’s in place. Ask your healthcare provider to explain how
- Reversible—You can have it removed by your healthcare provider at any time, and try to become pregnant right away
- Estrogen-free—It delivers small amounts of progestin locally into your uterus
- Approved to treat heavy periods—Mirena is the first and only birth control that is FDA-approved to treat heavy periods in women who choose intrauterine birth control
- Do not use Mirena if you have a pelvic infection, get infections easily, or have certain cancers.
What to expect at the doctor’s office:
A health care professional must insert and remove the IUD. He or she will review your medical history and will perform a pelvic exam. To insert the IUD, the IUD is placed in a slender plastic tube. The tube is inserted into the vagina and guided through the cervix into the uterus. The tube is withdrawn, leaving the IUD in place. Here’s the process in more detail:
- You will be asked to leave a urine sample, which will be tested to see if you are pregnant.
- Once it is confirmed that you are NOT pregnant, they will make arrangements to implant the IUD.
- You will be asked to undress from waist down and to lie on the table.
- The doctor will check your vagina, cervix and uterus to get a feel for the proper location of your uterus.
- She will insert clamps to …
Disinfect with iodine
Insert the applicator
Leave the T-shaped IUD in the uterus
Bring applicator out
Cut the cords/threads holding the IUD around 3 cm or longer.
After insertion, if you place your clean hands inside your vagina, you should be able to feel the threads. this indicates that the IUD is correctly in place.
Update: One year later
The first few weeks after the IUD was placed were a little rough as I had all the traditional symptoms of having hormones in the body – bleeding continuously (every day), mood swings, hot flashes etc. But the good news is that eventually, the bleeding stopped except for when it happens randomly now and then. During the monthly cycle, I do notice very light bleeding/spotting, much reduced cramps. I do still have mood swings, which may or may not be related to the IUD.
What’s next (follow-up)?
In order to preserve the warranty on the IUD for the five years, you need a yearly checkup by the doctor for up to 5 years or until you have the IUD removed. Your family doctor/PCP can do this and you do not need to see a specialist.
The checkup took just 5 minutes. The doctor had me in stirrups. She put on gloves and used a stainless steel speculum to check the inside. She felt for the threads and made sure they were intact. That’s it! All done!
Where can I learn more?
- ACOG website (FAQs Long-Acting Reversible Contraception (LARC): IUD and Implant)
- AHRP (Association of Reproductive Health Professionals) Website
- Mirena website (hormonal IUD- 5 years)
- Skyla Website (hormonal IUD- 3 years)
- Liletta Website (hormonal- 3 years)
- Paragard® Website (Copper IUD- 10 years)