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Talk to Your Doctor: Set it and Forget it Birth Control

In the past, when the discussion about birth control came up amongst my girlfriends, it often revolved around our preferred birth control pill rather than method. Lately, the conversation has taken a turn and many more of them are using or considering using a different method: long-acting reversible contraception. Of course, they don’t call it long-acting reversible contraception (LARC), they usually refer to intrauterine devices (IUDs).

Though IUDs are the most popular type of LARC, they are not the only type. Subdermal implants fall under the same category.  Both are non-user dependent methods of birth control that provide effective contraception for an extended period of time.  So their 'typical use' failure rates, at less than 1% per year, are about the same as 'perfect use' failure rates. Basically, LARC is a “set and forget” method of birth control. IUDs and subdermal implants are inserted once and work effectively for up to ten years (depending on the method). Because IUDs are more often used than the subdermal implant, and they continue to rise in popularity, we are going to focus our attention there.

Let’s start with the basics. An IUD, or intrauterine device, is a small ‘T' shaped device that is implanted in the uterus, where it releases small amounts of either copper or the hormone progestin to prevent pregnancy. With IUDs, it's estimated that between 0.2 percent and 0.8 percent of women will have an unplanned pregnancy within a year. In contrast, birth control pills and condoms must be used perfectly to be most effective. And with the way people typically use them, the unintended pregnancy rate is about nine percent per year. With condoms alone, it's between 18 and 21 percent. Bottom-line, LARC is an extremely effective form of birth control. Because of their effectiveness and safety, the American College of Obstetricians and Gynecologists (ACOG) says the devices should be offered as "first-line" options for most women.

If anyone you know has an IUD, you have probably heard about it. That’s because the IUD seems to turn every user into a walking advertisement. They all seem to go on and on about the freedom that comes from making the switch to a “set it and forget it” contraceptive. I’ve often heard the phrase, “I forget it’s even there, but I know it’s working.” Modern women are too busy trying to do it all to remember to take a pill every day or have an unplanned pregnancy. And IUDs solve the first issue and are extremely effective for the latter.

So why isn’t this safe and effective form of contraception being used more often? Unfortunately, there are many misconceptions about IUDs that have led to a lower usage rate in the US than in other countries. For every friend raving about how much they love their IUD, I have another saying, “I heard those are dangerous, especially if you haven’t had children.” This misconception is a repercussion of the first popularized IUD, manufactured in the 1970s: The Dalkon Shield. Heavily marketed 40 years ago, its design flaws contributed to many cases of Pelvic Inflammatory Disease (PID) and sterility, which led to its bad reputation. The IUDs available today are not your mothers’ IUDs! These new modern intrauterine devices are designed to avoid the flaws of the early models, are FDA-approved and have been safety tested for many years. However, though very rare, PID can still occur especially if you have a Sexually Transmitted Infection (STI). That’s why all Women’s Health CT physicians test patients for STIs before inserting an IUD.

Due to the Affordable Care Act, most insurance plans cover the cost of the device and insertion. This is something you can talk to your doctor about, after you discuss the risks and benefits of the intrauterine device. IUDs, while safe and effective, are not for everyone. All Women’s Health Connecticut doctors have been educated extensively on the three available IUDs and can provide patients with the necessary guidance.  Call your doctor to discuss this contraception option.  If you do not have an OB/GYN, request an appointment with a practice in your area.

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