Which LARC (Long-Acting Reversible Contraceptives) should I choose?
Are you tired of taking pills every day or having difficulty remembering to get injections every 3 months? There are long-acting reversible contraceptives (LARC) that you can choose to protect yourself from unplanned pregnancy which last for years. They are highly effective and convenient. There are two main types of LARC in the United States: 1) intrauterine devices (IUDs) and 2) the etonogestrel single-rod contraceptive implant (Nexplanon).
IUD is a T-shaped device that is placed inside the uterus. Among the IUDs, there are five IUDs that are currently marketed in the US: the copper-containing IUD (Paragard) and four levonorgestrel-releasing intrauterine devices (Mirena, Skyla, Liletta, Kyleena).
Copper IUD is wrapped with copper wire which prevent fertilization through inhibiting sperm migration and viability. This is a good choice for you if you are not planning on pregnancy for many years as you may keep the device up to 10 years. It is also a hormone-free device. However, the most common side effects reported are heavy menstrual bleeding and pain, therefore, not recommended for people with heavy menstrual bleeding.
Levonorgestrel-Releasing IUD is also a T-shaped device that is placed inside the uterus, but instead of copper, it includes a sleeve that contains hormone called levonorgestrel. Different brands have different doses of levonorgestrel, therefore, approved for different numbers of years (3 vs 5 years). They prevent pregnancy by causing cervical mucus thicker, making it impenetrable to sperms. It also diminishes menstrual bleeding because of the local effect of the hormone on the inner lining of the uterus, therefore, a great choice for people with problems of heavy menstrual bleeding. The most common side effect is irregular vaginal spotting or having no periods.
Contraceptive Implant (Nexplanon) is placed subdermally (under the skin) on your arm. It allows etonogestrel to be released in controlled fashion over 3 years. It is 4 cm long and 2 mm in diameter flexible single-rod implant. It works by suppressing ovulation. The contraceptive implant is the most effective method of reversible contraception available. This may be a good option for you if you do not wish any foreign body inserted into the uterus. The most common side effect is irregular bleeding and worsening of acne.
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