Monday, January 20, 2014

Long term birth control

No hassle birth control

Although there are several contraceptive methods currently available to women, most are unaware that there are long-term birth control options which are: extremely effective, convenient and well tolerated. Oral contraceptive pills can be an effective form of birth control but it can be a hassle to remember to take a pill each day. Patches and rings are effective as well, but there are many women in whom this method is not desirable. The three month progesterone injection (Depo Provera) is effective in preventing pregnancy, but there can be several significant side-effects related to this method. So, where do women turn to find a methdod of contraception that can offer higher effectiveness as well as convenience? The answer is that it may be time to try a LARC.

LARCs (long-acting reversible contraceptives) are either contraceptive implants or intrauterine devices that are effective from 3 to 10 years. As the name implies, LARCs are reversible, but what you may not know is that they are equal or more effective than a sterilization procedure. I will spend a little time briefly explaning each method but you can discuss these methods with your doctor in more depth.

Implanon, and the newer implant called Nexplanon (original I know), are both implants that are inserted under the skin in the upper, inner portion of the arm. They are both good for 3 years. The implant is inserted under local anesthestic (lidocaine, etc.) and is done in the office. Insertion is quick and easy however the removal can be a little more difficult depending on depth of insertion and scar tissue.

There a three intrauterine devices currently available in the US. Mirena (effective for 5 years) and Skyla (effective for 3 years) are the two IUDs that have a hormonal effect to your monthly cycle and both contain progesterone. Although Skyla is a newer product, Mirena has been used for years. In addition to being highly effective in preventing pregnancy, the progesterone containing IUDs can decrease the amount bleeding during your cycle (80% by 3 months and 90% by 6 months). There is a small chance (about 20%) that women using a progesterone containing IUD may not have a period at all! Just as the implant, the IUD is inserted in the office.

Paraguard is a non-hormonal IUD. Some women wish to have a hormone-free form of birth control and this presents an excellent, and effective, method for contraception. For women with heavy periods the Paraguard is probably not the best option as it does not reduce the amount of bleeding.

As you can see, there are 3 basic forms of LARCs available. Each one has it's pros and cons, but if a long-term, reversible option for birth control interests you, talk with your OB-GYN about your choices.

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