Long Acting Reversible Contraception

What is a LARC?

LARC is a Long-Acting Reversible Contraceptive, meaning that once it is inserted it will provide continuous protection against unwanted pregnancy until it is removed. There are two types of LARCs, implants or IUDs (Intrauterine Devices) and further subdivided into hormonal and non-hormonal. Both forms can be placed during a short in-office procedure and are more than 99 percent effective in preventing unwanted pregnancy.

The Implant

What is an implant?

The implant is a small, 4 cm rod that contains progesterone, a synthetic hormone. It is placed under the skin and provides up to 3 years of protection from unwanted pregnancy.

How is it placed?

An implant can be placed in your provider’s office with a short procedure. Before placement, the provider will clean your arm and then numb the spot where the device will be inserted. The device comes in its own applicator-syringe, which is used to inject the implant under the skin. It’s similar to getting a shot. The whole procedure takes around 10 seconds and is followed by dressing with a bandage similar to the kind worn after donating blood. The implant is invisible to the naked eye, but if you place your hand on your arm, you will be able to feel it just beneath the skin.

What are the side effects?

The most common side-effect with the implant is a change in your bleeding pattern. Some people may have a regular period, while the majority will have a lighter bleed or possibly just spotting. Some patients may not have any bleeding at all. You're not going to have a regular pattern at all, and that's okay.

Intrauterine Device

What is an IUD (Intrauterine Device)?

IUDs are small, flexible T-shaped, devices. They are inserted into the uterus during an office visit. They are easily removed by a provider when it needs to be replaced, or when you wish.

There are two different types of IUDs, hormonal and non-hormonal. Hormonal IUDs contain a small amount of synthetic progesterone that is slowly released into the body. This hormone works by thinning the lining uterus, preventing an egg from being released, and making it harder for sperm to survive.

There are several different brands of IUDs with different amounts of hormone in them. Hormonal IUDs can provide three to five years of protection from unwanted pregnancy before they must be removed. The non-hormonal IUD, is a similar in shape to the hormonal IUD, but is made of copper and contains no hormones. The copper IUD can be left in place for up to 10 years.

How is it placed?

Prior to placement of the IUD, your provider will likely do a brief pelvic exam to feel your uterus and see which way it's oriented in your pelvis. Your provider will then measure your uterus with a thin, plastic rod in order to find the best placement of the IUD. Both the measurement and placement can cause you to feel a cramping sensation, similar to a big menstrual cramp. For most people the discomfort is brief. The IUD is inserted with a straw-like applicator, through your cervix and into your uterus. Once it is in place, your provider will cut the strings attached to the bottom of the device so that it can be removed easily in the future. In total, the procedure takes around 5 minutes. Afterwards, some mild cramping is to be expected, but ibuprofen, naproxen, or heat can provide relief.

What are the side effects?

For the hormonal IUD, the most common side-effect is unscheduled bleeding. The majority of patients will have little to no bleeding. In the beginning, your periods may be more irregular, with frequent spotting, but this tends to resolve with time. For others, the irregularity may continue. You may also experience missed periods.

The main side-effect of non-hormonal IUDs is that is that it can make your periods longer and heavier. This makes the copper IUD a good option for those who already have manageable periods, but not for those with very painful cramps or really heavy flow.

Removal

Both implants and IUDs can be removed through a short, in-office procedure. Your ability to become pregnant should return quickly.

STDs

While LARCs protect against unwanted pregnancy, they do not protect against STDs. It is recommended that patients at risk for STDs also use condoms during intercourse.

Insurance

LARCs are covered by most insurance plans.

How to Decide?

Patients are encouraged to review their different options before coming to see their provider. Understand that there is not just one option for everyone, but rather that your provider is there to help you make the best option for your body and lifestyle.