So far in this blog series, we have focused on the two most common forms of birth control options used by teens; condoms and the birth control pill. For this post, we will be discussing LARCs. Of course, there are plenty of other birth control options, such as the Depo-Provera™ shot, the hormonal patch and NuvaRing®. These are also great options, but are much less popular than the condom, pill, and LARCs.
LARC is an acronym for long-acting reversible contraceptives. This means you get these types of birth control inserted into your body and basically don’t have to think about it again for anywhere between 3 and 12 years. Two great examples of long-acting reversible contraceptive options are the implant and the intrauterine device (IUD).
As with any birth control method, there are horror stories that scare teens away from taking the plunge and getting a LARC. LARCs do seem like kind of a big deal, because you actually have to go to your doctor and have them inserted, but they are very safe and very effective. I, personally, have had both the implant and the IUD, and I can assure you, the insertion for each is not scary in the slightest bit.
For starters, let’s focus on the implant. The implant (Nexplanon®) is a little plastic bar that is inserted under the skin of your arm (around your bicep area) by your doctor. It contains the hormone progestin that works in two ways to prevent pregnancy; this hormone thickens your cervical mucus to keep sperm from reaching an egg, and it also works to prevent your ovaries from releasing an egg in the first place.
The implant can be a great option for teens because once it’s inserted, you never have to worry about it again for up to 4 years! Of course, using a condom as well is important because the implant does not prevent the contraction of STIs. Once the implant is inserted, it is nearly undetectable. You may have a tiny dot scar at the place of insertion, but besides that, nobody would ever know there was an implant in your arm. This is great for teens who don’t want people to know they are on a form of birth control!
The insertion process for the implant is simple! It is almost just like getting a shot. The implant is placed on the inside of your upper arm, and it is inserted through a needle. Before getting mine, my doctor went over the process and showed me the device used to insert the implant. It was nearly pain-free. The worse part of the process was getting a shot in my arm that numbed the area before the insertion! A lot of teens worry about birth control methods like the implant because it requires a doctor’s visit and a “procedure.” However, it is very simple, safe, and pain-free.
The implant can be expensive, but it is covered by most insurance plans! If you are not insured or do not want the implant to go through your parent’s insurance, check with your local Family Planning to see what options they might have for free or low-cost implants! The arm implant is over 99% effective, and it’s a great option for teens because there really isn’t any responsibility to maintaining that effectiveness like there is with the daily oral contraceptive.
The implant can cause some irregular bleeding or spotting for 3-6 months after insertion, but otherwise is very safe and free of any serious side effects. If you want more information about the implant, be sure to contact your local family planning clinic http://www.mainefamilyplanning.org/ or check out Bedsider for all the pros and cons of Nexplanon® here: https://www.bedsider.org/methods/implant#side_effects
The IUD is a bit different than the implant because it is a T-Shaped piece of plastic that is placed in your uterus. All IUDs work similarly by making your uterus too hostile an environment for pregnancy. There are hormonal IUDs that also use hormones to stop conception, and non-hormonal IUDs that prevent pregnancy without the use of hormones. The non-hormonal option is great for people who cannot have hormonal birth control!
There are four types of hormonal IUDs—Mirena®, Skyla®, Liletta®, and Kyleena™. These hormonal IUDs are effective from anywhere between 3 and 6 years depending on which type is best for you. They vary in size as well, assuring that there is an IUD to fit every woman, regardless if they’ve had children or not.
There is only one type of non-hormonal IUD and it is Paragard®. Paragard® is made of plastic and copper and works for up to 12 years!
An IUD is a great birth control option for teens, because, like the implant, once it is inserted it will protect from an unwanted pregnancy until it is removed. Just like with the implant, it is important to continue to use condoms even after you have an IUD inserted. IUDs are excellent at preventing pregnancy, but they do not prevent STIs.
This can be a scary option for teens, because having an IUD inserted requires a doctor’s visit. You can get an IUD inserted at any point in your cycle, but it is best to do while you are on your period because that is the point during your menstrual cycle that your cervix is the most soft and open. Call your doctor or your local family planning clinic to find out if the IUD is a good option for you!
Like I stated above, I have had both an implant and an IUD. I, too, was terrified to take the plunge and get an IUD because I was worried that it might hurt! So, I want to tell you in detail how the whole insertion process works so you can know what to expect if you think an IUD is a good option for you.
Before getting an IUD, my doctor suggested taking Tylenol about an hour before my appointment. This is good because often there is some cramping after insertion, so the Tylenol makes that cramping a bit more bearable. Personally, I’ve always had pretty painful periods, so that’s the type of painful cramping I was expecting, and that’s just what it turned out to feel like. At the office, you’re asked to take your pants off and sit on the table with a sheet over yourself just like you would for a pap smear. Easy enough!
At my appointment, my doctor came in and explained in detail every little thing about the Mirena® IUD, and told me exactly how the insertion would be done. First, they would go in (using tools just like with a pap smear) and look at my cervix. The worse part of the whole process is a little pinch when they grab onto your cervix to steady it so they can get to your uterus. Honestly, the pinch was uncomfortable, but it wasn’t necessarily painful.
Once they’ve grabbed a hold of your cervix, the hard part is over! They first use a tool to measure your uterus (to make sure it’s the correct size for whatever IUD you have chosen,) and then they insert the IUD. Once it is inserted, they trim the little string attached to the device and you’re done! That little string will curl around your cervix in time. The string is there as a way to check that the IUD is still in the cervix where it belongs, and it comes in handy in 3-6 years when you’ll need to have your IUD removed.
If, after having an IUD inserted, your partner can feel it during sex, call your doctor. The string can be cut shorter if need be so that it can’t be felt during sex. Often if the string is cut too short in the first place, it can’t curl around the cervix and can poke your partner during sex.
You’ll usually have a follow up appointment in a month or so just to check that everything is all set. Often, this is a good time for the doctor to trim the string if your partner is feeling it during sex. After this checkup, your doctor will just check on that little string at your yearly exam.
After insertion of my IUD, I was a bit crampy for the rest of that day, but after that everything felt completely normal and suddenly I didn’t have to worry about taking a birth control pill at the same time every day anymore!
The costs for IUDs vary, but they are covered by most insurances. If you do not have insurance, contact your local family planning clinic to see if you can get an IUD for free or at a reduced cost.
IUDs are over 99% effective, and are the longest lasting form of birth control. This is also a great option because there are both hormonal and non-hormonal options. The Mirena® IUD is a good option for women who have heavy and painful periods, and it often stops women from having their period! As with any type of birth control, IUDs can cause some irregular bleeding in the first few months while your body adjusts, but this is normal. Lots of women stop having a period after the first few months of having an IUD.
If you have any questions, contact your local family planning clinic http://www.mainefamilyplanning.org/directories/24/clinic-locations or check out Bedsider for more detailed information about the pros and cons of IUDs here: https://www.bedsider.org/methods/iud#side_effects
Chynna is attending the University of Maine pursuing graduate work in the field of human development with a focus in human sexuality. She is originally from Maine and enjoys spending her free time taking her dog for walks on campus.