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Long Acting Reversible Contraception - IUD and Implant

Is Long Acting, Reversible Contraception right for you?

Benefits:

+ Available to most women of reproductive age, with or without children, single or in a relationship

+ Highly effective (>99%)

+ Requires very little effort. 

+ Extended duration of effectiveness (3-12 years depending on device). All devices can be removed by a medical professional anytime during the lifespan of the device to switch methods or restore fertility.

+ Provides quick restoration of fertility after removal by a medical professional.

Cost:

Professional insertion and removal fees plus the cost of the device may seem high, but these costs are more cost-effective over time than other contraceptive options such as the pill, patch or ring.  Additionally, many insurance companies will pay a significant portion of the cost for the contraceptive device and insertion/removal fees. Use our IUD/Implant Insurance Worksheet (see right sidebar) to help you determine what your insurance will cover. Long acting reversible contraception options are generally covered by UNC sponsored health insurance plans. 

Types of Long Acting, Reversible Contraception

Non-Hormonal Copper IUD  (Paragard®)

Effective for up to 12 years

Effectiveness: >99%

+ Pros: No hormones. Highly effective. Longest lasting contraceptive option available. Reduced risk of endometrial cancer. Most effective emergency contraception available.

- Cons: Stronger cramps with your period, longer periods are possible. Some risk of the uterus expelling the device, which would result in fertility restoration. Rarely perforation of the uterus could occur at the time of placement. No protection against sexually transmitted infections.

How it works: The IUD’s (intrauterine device’s) precise mechanism is not known; likely several factors are involved. Pregnancy appears to be prevented by the changes in the uterine environment as a result of the introduction of a foreign body (the IUD) and copper that impairs sperm and ova function as well as prevents fertilization.

Hormonal IUD (Mirena® / Skyla® / Kyleena®)

Effective for up to:

  • 5 (to 7) years Mirena®
  • 5 years Kyleena®
  • 3 years Skyla®

Effectiveness: >99%

+ Pros: Highly effective. Lighter and less painful periods or no periods. Reduced anemia. Reduced symptoms of endometriosis. Lower risk of endometrial cancer. Lower levels of hormones than the pill, patch or ring.

- Cons: Lighter periods or no bleeding at all. Less common side effects include hair & skin changes, bloating, headache, breast pain, mood changes, nausea and ovarian cysts. Some risk of uterus expelling the device, which would result in fertility restoration. Rarely perforation of the uterus could occur at the time of placement. No protection against sexually transmitted infections.

How it works: The IUD’s precise mechanism is not known; likely several factors are involved. Pregnancy appears to be prevented by the changes in the uterine environment as a result of the introduction of a foreign body (the IUD) and the local effects of the hormone progestin including thickening cervical mucus.

Skyla® and Kyleena® are built from the same frame. Mirena® is slightly larger than Skyla® and Kyleena®. Mirena® has the highest amount of hormone followed by Kyleena® then Skyla®.

Implant (Nexplanon®)

Effective for up to 3 years

Effectiveness: >99.9%

+ Pros: Highly effective. Reduced or no periods over time. Reduced anemia. Reduced symptoms of endometriosis.

- Cons: Possible irregular bleeding and sometimes no bleeding after one year of use. Possible decreased effectiveness with certain medications such as St. John’s Wort, carbamazepine, and rifampin. Less common side effects include hair & skin changes, bloating, headache, breast pain, mood changes, and nausea. No protection against sexually transmitted infections. 

How it works: The implant is inserted under the skin in the upper arm, where it releases the hormone progestin. The progestin prevents ovulation, thickens cervical mucus, and prevents thickening of the endometrial lining.

For further questions, please contact your medical provider, pharmacist or a Sexual Wellness Specialist (sexualwellness@unc.edu).