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So you’ve chosen not to get pregnant, or maybe you’ve decided not to have more kids, at least for now. If pregnancy is a possibility for you, and if you’re sexually active with people of the opposite sex, your next decision is just as important: How to prevent it? Which methods of birth control are safe, reliable, convenient, accessible, and free or low-cost?

Birth control implants and intrauterine devices (IUDs)—two methods of long-acting reversible contraception (LARC)—may be for you. “LARC methods are perfect for students with unpredictable schedules,” says Dr. Julie Strickland of the American College of Obstetricians and Gynecologists. Implants and intrauterine devices (IUDs) can prevent pregnancy for 3–10 years. These are the most reliable forms of birth control because they’re so low maintenance. No need to take a daily pill, replace a weekly patch, and so on.

Many students are unfamiliar with IUDs and implants, and may not know if they are a reasonable option. “Don’t knock it till you try it. As with all birth control methods, some will work for some women, and others will not,” says Dr. Colleen Krajewski, medical advisor to Bedsider.org, an online birth control support network. In a recent survey by Student Health 101, 39 percent of respondents expressed a lack of confidence in their knowledge about IUDs and implants (37 percent felt well informed, and 24 percent felt they didn’t need to know). On the next page, we put your questions to our panel of student-friendly LARC experts.

Long-acting reversible contraception: Your options

Intrauterine device

Intrauterine device (IUD)

This T-shaped device is about the length of a paperclip. A health care provider inserts it into the uterus. A short string hangs down into the vagina, so the device can be easily removed when it is no longer viable or needed. There are two types of IUD:

The hormonal IUD releases progestin. This thins the lining of the uterus, making it harder for a fertilized egg to implant. It also thickens the cervical mucus, so sperm have less access to the uterus. It may also prevent the ovary from releasing an egg. The hormonal IUD is effective for 3–5 years. A newer brand, Skyla, is intended to be more comfortable to insert. Brand names: Skyla, Mirena, and Liletta.

The copper IUD does not contain hormones. The copper IUD works by inhibiting sperm mobility and egg fertilization, and possibly inhibiting implantation of the egg. The copper IUD is effective for up to 12 years. Brand name: ParaGard.

Implant

Implant

This flexible, matchstick-sized rod is inserted under the skin of your upper arm. It releases progestin, like the hormonal IUD, thinning the uterine lining and thickening the cervical mucus to prevent pregnancy. It also prevents an egg from being released. The implant is effective for up to three years. Brand name: Nexplanon.

LARC methods do not protect against sexually transmitted infections. For STI protection, you still need to use condoms and/or latex dams.

+ Find out now: Can you get free birth control?
+ Without insurance, how much does an implant cost?

Question

How reliable are IUDs and implants at preventing pregnancy?

Answer

“LARCs are the most effective form of birth control available—[some LARC devices are] more than 99 percent effective at preventing pregnancy. With a LARC device in place, you’re protected from pregnancy for 3 to 10 years, depending on the method selected.”
—Dr. Alyssa Bennett, clinical fellow in adolescent medicine, Boston Children’s Hospital, Massachusetts

Compare LARC methods to condoms and the Pill

“In comparison, [with typical use] birth control pills have a failure rate of about 9 percent, and condoms have a failure rate of 18 percent! A lot of young women don’t realize that accidentally taking the Pill at different times during the day, or missing a pill, can actually lead to an unintended pregnancy.”
—Dr. Julie Strickland, practicing OB-GYN, Truman Medical Center Hospital Hill in Kansas City, Missouri; chair, Committee on Adolescent Health Care, American College of Obstetricians and Gynecologists

Students’ stories
“Implant method! I strongly suggest this method for all women who do not want to get pregnant! And I have experienced no adverse side effects!”
—Fourth-year student, Golden West College, California

“As a partner of someone using an IUD, it’s really reassuring to not have any ‘whoops’ moments.”
—Student, Roanoke College, Virginia

“I think that [LARC] is extremely awesome. I am busy all the time, and not having to worry about scheduling an appointment or taking a pill is really convenient for my lifestyle.”
—First-year graduate student, California State University, San Bernardino

Question

What are the side effects of LARC methods?

Answer

“Overall, most women who choose LARC methods experience few side effects except for slight changes in their menstrual bleeding, which are common with both the IUD and birth control implant.” (Some women stop bleeding entirely or their periods become much lighter. The copper IUD can be more disruptive to the menstrual cycle.)
—Dr. Alyssa Bennett

Experts and students talk side effects

“With the hormonal IUD, approximately 25 percent of women won’t have a period at all. The copper IUD can cause periods to become heavier or crampier. For both, you may experience cramping or a low backache for up to a few weeks after insertion. There’s also a slightly increased risk of infection, called pelvic inflammatory disease (PID), during the first 20 days after the IUD is inserted. After that, the risk for PID is very low. Very rarely, the uterus can be injured when the IUD is inserted.

“With the birth control implant, changes in menstrual bleeding patterns are less predictable than those with an IUD. About a third of women have lighter periods and 20 percent will have no periods, while some have reported heavier bleeding. Other less common side effects include headaches, weight gain (likely related to changes in appetite), scalp hair loss, acne, and mood changes such as depression or nervousness.”
—Dr. Alyssa Bennett, clinical fellow in adolescent medicine, Boston Children’s Hospital, Massachusetts

“The IUD can make women’s periods more manageable and [sometimes] more predictable. The implant can make bleeding unpredictable. There is no way to know which group you are in beforehand.”
—Dr. Colleen Krajewski, practicing OB-GYN; assistant professor at the University of Pittsburgh Magee-Women’s Hospital, Pennsylvania; medical advisor to Bedsider.org

Question

Will a LARC affect my ability to get pregnant later?

Answer

“The ‘R’ in LARC stands for ‘reversible.’ This means that LARC methods do not affect future pregnancies. If ever you want to become pregnant, simply have the device removed. You can start trying to become pregnant immediately.”
—Dr. Julie Strickland

Question

What makes IUDs and implants so convenient?

Answer

“With a LARC method, it’s unlikely that you’ll have to worry about a surprise pregnancy on top of everything else you juggle in your life. LARCs remove the human error from birth control, making contraception [almost] worry-proof. You make an appointment with your health care provider, and once the IUD or implant has been inserted, you don’t have to do anything or remember anything to be protected against pregnancy.” (It is a good idea to feel for the strings to check that it’s in place. There is a small risk of your body expelling an IUD and leaving you unprotected from pregnancy.)
—Dr. Julie Strickland, practicing OB-GYN, Truman Medical Center Hospital Hill in Kansas City, Missouri; chair, Committee on Adolescent Health Care, American College of Obstetricians and Gynecologists

Question

How much do IUDs and implants cost?

Answer

“Under the Affordable Care Act, insurance plans must cover the full range of FDA-approved birth control methods (including the IUD and the implant) for free, without a co-pay (a fee charged to the patient, on top of what’s covered by insurance). Some plans will require a co-pay for certain brands of birth control, however, so you should check your insurance plan to find out which brands are fully covered.”
—Dr. Vanessa Cullins, vice president of external medical affairs, Planned Parenthood Federation of America, New York

Check out what LARCs cost

IUD costs without insurance
With no insurance coverage, the cost of the medical exam, insertion of the IUD, and follow-up visits to your health care provider could potentially add up to $1,000 (generally between $500 and $900). That pays for protection that can last from 5–10 years, depending on which IUD you choose. In general, hormonal IUDs are more expensive than the non-hormonal copper IUD.

Implant costs without insurance
With no insurance coverage, the cost of the exam, the implant, and insertion ranges can be up to $800. Removing the implant costs up to $300. This pays for pregnancy protection that can last for three years.

+ Can you get free birth control? Find out

Question

Are there any LARC methods on the market for men?

Answer

“There are no LARC methods on the market for men. LARCS do not protect against sexually transmitted infections (STIs). Although condoms aren’t as effective as LARC methods at preventing pregnancy, they are essential for safeguarding yourself against STIs.”
—Dr. Julie Strickland

+ Without insurance, how much does an IUD cost?

+ For accurate prices, call your local Planned Parenthood

Jenna L

Jenna L.: First-year graduate student at the University of Colorado, Anschutz Medical Campus, in Aurora, Colorado, studying public health.

“The app allows you to search for places in your area that offer free condoms. All you need to do is either click ‘Search Near Me’ or enter a specific zip code, and tons of locations come up. It also offers live stats on rates of HIV infections in the US.”

Useful?
“The app does a good job at promoting safer sex through condom use, accessibility, and availability.” 
Rating: 5/5 stars

Fun?
“How fun can looking at the rates of HIV infections in the country really be? It is fun to see how many random places (like nearby nightclubs) give out condoms though.”
Rating: 4/5 stars

Effective?
“The app makes it so easy to locate places giving away free condoms and literally maps your route to get there.”
Rating: 5/5 stars

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Renée Morrison completed her bachelor’s degree in journalism at Concordia University in Montreal and works as a freelance writer covering travel, health, and wellness topics.