Long-Acting Reversible Contraceptives(LARC)

What is A Long-Acting Reversible Contraceptive?

Long-acting reversible contraceptive methods are options for women who want to delay pregnancy for several years and who don’t want the hassle of coming in regularly to a clinic, or pharmacy to get refills of their methods or to get injections. LARC methods are safe, reliable, and reversible – which means a woman can get pregnant once they are removed. Two methods of LARC are the Intra-uterine device (IUD) and the Implant.

The IUD

What is the IUD?

The IUD (intra-uterine device) is made of plastic and looks like a “T.” There are 3 types:

  • Skyla and Liletta (lasts for 3 years)
  • Mirena (lasts for 5 years)
  • Paraguard (lasts for 10 years)

How does the IUD work?

During a procedure, a health professional will insert the IUD into your uterus

In order for a pregnancy to happen, sperm have to find and “hook up” with an egg. In general, IUDs work by making it very hard for that to happen by preventing sperm from reaching the egg. Some types of IUDs (Skyla, Lilleta and Mirena) contain a hormone which can make your periods lighter. The 4th type (Paraguard) has NO hormones, can last longer (10 years) but you may have heavier periods for awhile.

How well does it work?

IUDs are among the MOST effective types of contraceptive methods. Less than 1 out of every 100 women who use an IUD will get pregnant.

What are the benefits of using an IUD?

  • Very safe
  • Very effective – You won’t have to worry about getting pregnant!
  • No more trips to the pharmacy to pick up birth control (although you still need to keep stocked with condoms. The IUD does NOT protect against STDs and HIV)
  • Very few trips to the clinic (once to put it in, once to take it out! Of course, you should see your health provider for regular check-ups or if you are not feeling well)
  • Some types of IUDs (Skyla, Lilleta and Mirena) contain a hormone which can make your periods lighter, and your may have fewer menstrual cramps
  • You are in control! They last for years so you can deal with all the other important things in your life…like school, your job, family, relationships and whatnot
  • Having a procedure – the IUD needs to be put in by a health provider and it may be a little uncomfortable. They will give you medicine before and after to help with the discomfort
  • Cramps – after putting the IUD in, you may have cramps and backaches for a few days. Again, you will get medication to help with the discomfort. Some types of IUDs, like Paraguard, may cause cramps for several months afterwards
  • Bleeding – with hormonal IUDS (Sklya, Lilleta, Mirena) you may have light periods and spotting for several months. With Paraguard, your periods may be heavier

How can I get it?

You will need to come to a clinic or a doctor’s office to get the IUD.

How much does it cost?

Medicaid and many insurance plans will cover the costs which can be close to $1000 depending on the method if you don’t have insurance. So, get insured! If you need help finding coverage, log onto SingleStop to find a site near where you live or work to get assistance with getting medical insurance

Implants

What is an Implant?

The implant is a single, thin rod or tube containing hormones that is inserted under the skin of a women’s upper arm. It protects against pregnancy for up to three years. The implant is available under the brand names Implanon and Nexplanon.

How does the Implant work and prevent pregnancy?

The implant releases a hormone called progestin into the body. The progestin in the implant works by keeping eggs leaving the ovaries (ovulation). Without ovulation you can’t get pregnant. The implant lasts for three years.

What is the process for putting the implant in your arm?

Your health care provider will give you medicine to make your arm numb for a few minutes. Then they will slip the small implant under the skin. It will only take a few minutes. The implant can be removed at any time. To do so, your health provider will give you medicine to make your arm numb again. They will usually make a small cut to find and remove the implant. Removal usually takes just a few minutes. A new implant may be inserted at this time, if you want to stay protected and not get pregnant. Or, if you have decided to try a different method or you are ready to get pregnant, the implant will be taken out. A pregnancy can happen after the implant is removed.

How well does it work?

If you get the implant during the first five days of your period, you are protected against pregnancy immediately. Otherwise, you need to use some form of backup birth control — like a condom, female condom, diaphragm, or the sponge.

Less than 1 out of 100 women a year will become pregnant using the implant.

Certain medicines and vitamin or herbal supplements may make the implant less effective. Talk to your health care provider about the medications you are taking or plan to take. These hormonal implants don’t protect against sexually transmitted diseases (STIs). Use a male or female condom to reduce the risk of infection.

What are the benefits of an Implant?

  • The implant is safe
  • The implant works well to prevent pregnancy for up to three years
  • When you are ready, you can become pregnant after your health provider removes the implant
  • It’s easy! You don’t have to remember to take a pill every day put in (and take out a ring) every month
  • For most women, periods become fewer and lighter. After one year, 1 out of 3 women who use the birth control implant will stop having periods completely. After you stop using the Implant, your body will go back to normal and you will get your period back
  • It can be used while breastfeeding
  • It can be used by women who cannot take estrogen

What’s the downside of using the Implant?

  • Some women have increased spotting and light bleeding between periods Some women have longer, heavier periods
  • The implant cannot be used by women who have breast cancer
  • Sometimes, some women may have a change in sex drive. They may feel less likely to “be in the mood” to have sex
  • Discoloring or scarring of the skin over the implant
  • Headache
  • Nausea
  • Pain at the place where the implant was inserted
  • Sore breasts
  • Weight gain
  • It is important to have a good relationship with your health provider and let them know about any changes in your body so they can help figure out how to make you feel better

How can I get it?

See a health care provider to get the birth control implant. You will need to share your medical history and get a physical exam

How much does it cost?

The cost of the exam, the implant, and insertion ranges from $0–$800. Removal costs between $0 and $300 But, Medicaid and many private insurance plans will cover most, if not all of the costs other state programs should pay for it. If you need help finding insurance, log onto SingleStop to find a site near where you live or work to get assistance with getting medical insurance. Also, Project STAY can help you get what you need. Call us at 646-685-9639.

Need help now?

For more information, text or call Renee Cohall, LCSW-R, Director of Special Initiatives, at 646-245-4000.