Would an IUD or birth control implant work for me?

It’s happened to many women – that sinking feeling when you forget to take your birth control pill, or a condom breaks. It can be really stressful to have to think about birth control every day or in the heat of the moment. If you think condoms and the birth control pill are your only contraceptive options, think again.

While “the pill” remains the most popular form of contraception for women, long-acting reversible contraceptive methods (LARCs) are quickly catching up.

According to November 2015 data from the Centers for Disease Control and the National Center for Health Statistics, LARCs such as the intrauterine device (IUD) and the birth control implant have nearly doubled in popularity. In 2010, 6 percent of women who used contraception picked a LARC; in 2013, 11.6 percent chose a LARC. According to the data, among those women using a LARC, 10.3 percent used an IUD and 1.3 percent used an implant.

The failure rate for the pill is 9 percent, compared to just 0.05 percent to 0.8 percent for LARCs. Why are LARCs so effective? Unlike the pill or condoms, you don’t have to remember to use an IUD or a birth control implant. Once it’s placed, that’s it – no pills to think about or emergency trips to the drug store!

IUDs and birth control implants last for years once they’re implanted, but can be removed easily if you want to become pregnant. LARCs also can be used for more than contraception – to help with irregular menstrual cycles, heavy bleeding, headaches, and other medical issues.

Both are safe, effective options, but which one should you choose? Here’s a breakdown of the basic information, benefits, and risks associated with IUDs and birth control implants.

What’s an IUD?

The IUD is a small, T-shaped device that is inserted into the uterus by your physician. Insertion only takes a few minutes. It may feel uncomfortable, like a prolonged pelvic exam, but it’s not painful for most women.

You may have heard that you can only get an IUD if you’ve already had a child. This used to be true, but not any longer. It’s sometimes easier to insert an IUD if you’ve already given birth, but it’s still safe and simple to place if you haven’t.

There are two types of IUDs:

• The hormonal IUD releases the hormone progestin, which prevents pregnancy by thickening the cervical mucus so sperm can’t get into the uterus. It also keeps the lining of the uterus thin, making is less likely a fertilized egg would attach to it.
  • The benefits: This type of IUD is approved for use up to 5 years, depending on the brand. Many women eventually stop having their periods when an IUD is inserted.
  • The downside: You may experience spotting and irregular bleeding in the first few months, but the amount of bleeding, length of the period, and amount of menstrual pain usually decreases over time. A few women may experience hormonal side effects, such as headaches, nausea, and depression.
• The copper IUD does not contain hormones, but instead has copper wire coiled around the stem. The copper is toxic to sperm and makes the uterus and fallopian tubes produce fluid that kills sperm.
  • The benefits: The copper IUD is approved for use up to 10 years. You will continue to have your normal periods while using the copper IUD.
  • The downside: You may experience heavier menstrual bleeding and pain in the first few months of use, but this usually decreases after a year.

Most insurances cover the cost of IUDs. When your IUD is close to expiring, or if you decide to become pregnant or try a different option, your physician can remove the IUD in a matter of minutes in the office.

Complications from an IUD are rare, but can occur. These can include:

• The IUD coming out of the uterus.
• The IUD piercing the wall of the uterus during insertion.
• Pelvic inflammatory disease.
• In the rare case a pregnancy occurs, there is a higher chance of an ectopic pregnancy, in which a fertilized egg implants outside the uterus.

What is a birth control implant?

The birth control implant is a matchstick-size rod that we insert under the skin in your upper arm. The progestin hormone in the implant prevents pregnancy by stopping ovulation. The hormones thicken the cervical mucus, making it hard for sperm to get in the uterus and fertilize the egg. It also keeps the lining of the uterus thin, making it more difficult for a fertilized egg to attach to it.

Insertion only takes a few minutes. We’ll numb your upper arm with a local anesthetic and place the implant with a special inserter. When it expires or when you’re ready, we’ll remove the implant with a small incision in your arm.

• The benefits: This method can last up to three years. You also may have less menstrual pain, and bleeding may stop completely. Most insurances cover the cost of the implant.
• The downside: You may experience unpredictable bleeding, which for some women improves over time.

Complications are rare, but if you become pregnant while using the implant, there is a slightly increased risk for ectopic pregnancy.

How to decide which is best for you

Birth control methods aren’t one size fits all. What works for your sister or friend may not work for you. You may need to try different options before finding the right LARC for you.

When deciding on a contraceptive method, consider these questions:

• Will it protect against sexually transmitted infections (STIs)? Many contraceptive methods, including the pill and LARCs, don’t protect against STIs.
• How effective is it?
• Will you be able to use it consistently and correctly?
• What are the side effects and risks?

While most of our patients use the birth control pill and find it to be an effective form of contraception, it’s important for women to know that there are many options. Talk to your physician about what method might work best for you.