Historically, birth control was a wheel of pills, one for each day of the week. The iconic image of the circular pill pack comes to mind for most when they hear someone mention birth control. Technology has eclipsed the traditional pill, and now women can choose from a variety of birth control options. Long-acting reversible contraceptives (LARCs) include: the Intrauterine Device, Progestin subdermal implant and Depo Provera. The beauty of LARCs is that they serve as birth control for a long duration but can also be discontinued immediately. The important question is: which birth control option is best for you?
LARC, like the IUD (Intrauterine Device), is efficient and growing in popularity among women searching for alternatives to a daily pill. As more women seek alternatives to the pill or patch, we asked Dr. Meagan Morrison at Atrium Health Women’s Care North Charlotte OB-GYN, to shine some light on the increasingly popular birth control methods.
Question 1: What is an IUD?
Answer 1 | Morrison: An intrauterine device (IUD) is a type of long-acting reversible birth control. IUDs are small plastic T-shaped devices placed in the uterus. There are two types of IUDs available in the United States. One type has copper (hormone free) and the other type releases the hormone progesterone.
Q2: How does an IUD work differently from a pill?
A2 | Morrison: The copper IUD works by interfering with sperm movement, egg fertilization, and possibly prevents implantation. Progestin IUDs work by thickening the cervical mucus to prevent sperm from entering the uterus, thinning the lining of the uterus and inhibiting sperm from fertilizing the egg. The progestin can also prevent ovulation (same mechanism of action as the pill).
Q3: How effective is an IUD?
A3 | Morrison: Both types of IUDs are more than 99% effective in preventing pregnancy when placed properly.
Q4: What are symptoms after getting an IUD?
A4 | Morrison: After an IUD is placed in the uterus, some patients feel discomfort, cramping, or occasional irregular bleeding. Over-the-counter medications can help reduce the intensity and duration of cramping. Some of these medications like NSAIDs (non-steroidal anti-inflammatory drugs) can help with any associated irregular bleeding.
Q5: Are there side effects to an IUD?
A6 | Morrison: The copper IUD may cause some women to have heavier bleeding and a longer menstrual cycle. Progestin IUDs, on the other hand, usually diminish or stop a woman’s menstrual bleeding. Some women may have irregular spotting (small bleeding between periods) and bleeding. IUDs do not protect women from or prevent the spread of sexually transmitted infections. If spotting or bleeding occurs, reach out to your doctor. Additional medications can be prescribed to eliminate these side effects.
Q6: Which IUD is right for me?
A6 | Morrison: Women should discuss with their physician the benefits of an IUD. There are several different kinds of IUDs available, and they can vary in duration and hormone levels.
Q7: What is the birth control that is placed in the arm?
A7 | Morrison: A progestin subdermal implant (Nexplanon) is a small rod-shaped device that is 1.6 inches in length. It is placed under the skin in the right or left medial arm and should be palpable, but not visible. This method of birth control is quickly gaining popularity as it usually takes one to two minutes to place and lasts for three years. We inject the skin with numbing medication (Lidocaine) and then place the rod with a small needle device. Most patients note minimal pain with placement. The most common side effect is spotting. If spotting or bleeding occurs, reach out to your doctor. Additional medications can be prescribed to eliminate these side effects.
Q8: What is the Depo-Provera shot?
A8 | Morrison: The Depo-Provera injection continues to show popularity. It is an intramuscular injection placed in the arm or gluteal region every three months. The benefit of the Depo shot is that it can completely take away a period. For women with heavy and painful periods, or, for women who want to avoid monthly bleeding then the Depo-Provera shot is a great option. The most common side effect is weight gain and spotting. If spotting or bleeding occurs, reach out to your doctor. Additional medications can be prescribed to eliminate these side effects. Weight gain only occurs when calorie intake exceeds a person’s normal intake. Being mindful of one’s diet helps to prevent this side effect.
Q9: Will the IUD, progestin subdermal implant or Depo Provera shot cause infertility?
A9 | Morrison: I reassure my patients that the LARCs simply prevent pregnancy while in use but do not negatively affect fertility. The strongest contributor to infertility is time, waiting too long to get pregnant.
Q10: Does the IUD or subdermal implant cause pain?
A10 | Morrison: It is rare that an IUD will cause pain but can if it is placed in the wrong location. If there are any concerns, the IUD and rod can be readily removed.
Learn more about Atrium Health Women’s Care. Call 704-468-8884 to schedule an appointment.
