After being plagued by with a bad reputation and lack of awareness, long-acting reversible contraceptives (LARC) are finally gaining much-deserved momentum. The Guttmacher Institute recently reported that U.S. women are increasingly turning to highly effective LARC methods—particularly intrauterine devices (IUDs). According to the report, the IUD and the contraceptive implant use increased from about 9% in 2009 to nearly 12% in 2012.
As a physician, I can personally vouch for the fact that IUDs are the most popular method of birth control used by family planning practitioners — we know firsthand about their safety profile and efficacy. With failure rates of less than 1% per year, LARCs are the most effective reversible methods available.
Most women are excellent IUD candidates, regardless of age or whether they’ve had children or not. And depending on what IUD option they choose, they don’t need to worry about birth control for three, five, or 10 years.
Despite all of this great news, those of us who work in reproductive health and family planning still have to counter the misinformation, especially about IUDs, on a regular basis. Sometimes a patient will tell me that she’s interested in getting an IUD but that a friend told her that they were dangerous, or that she heard only women who have had kids can use them. I always explain what I know to be true: IUDs are safe and effective and appropriate for women of all ages.
The implant (Nexplanon®) is a popular method with my younger patients, which isn’t a surprise. In one large contraceptive study, over 40% of those surveyed under 18 opted for the implant. Smaller than a matchstick, it is discreet and hidden under the skin of the inner arm. It is an easy two-minute insertion that feels like getting a shot and doesn’t require a pelvic exam. It has the lowest failure rate of any form of contraception — 0.05% — and works for three years.
LARCs are fantastic—they’re highly effective and low-maintenance. But I always tell my patients that the best birth control method for them is the one that they choose for themselves—and the one they feel most comfortable using. That’s why we discuss all the options available, the full range of contraceptive methods, including LARC methods.
If you are a health care practitioner looking to learn more about LARC, here are some great resources:
- The NYC IUD Taskforce offers resource pages that are valuable for providers everywhere on Adolescents and IUDs, IUD as EC, and same-day insertion.
- Our Adolescent Reproductive and Sexual Health Education Program features a PowerPoint presentation for health care providers, available for download: “Long-Acting Reversible Contraception (LARC): First-Line Care for Adolescents.”
- If you would like to learn more about copper IUDs as emergency contraception, download our emergency contraception practitioner’s guide.