Is an IUD the right birth control for you?

Lawren Honken, MD

Obstetrics and Gynecology

When most of us think about contraception, we think about condoms or about the stereotypical box of daily pills. For many, it is difficult to reliably take the pill every single day. Additional methods of birth control that won’t affect future fertility are available, including long-acting reversible contraception, or LARC. The most widely known form of LARC is the IUD.

Lawren Honken, MD, explained what options exist, how IUDs and other forms of long-acting contraception work, and how to know if an IUD is the right birth control for you.

What is long-acting reversible contraception (LARC), exactly?

“LARC is exactly what it sounds like,” said Dr. Honken. “Long-acting reversible contraception is designed to prevent pregnancy for 3–10 years, depending on the method, and when you are ready to become pregnant, it can be removed without affecting future fertility.”

What types of LARC are available?

Many people already know about IUDs, small, T-shaped devices implanted directly within the uterus. Another option for long-lasting contraception includes a single-rod arm implant that releases etonogestrel to prevent pregnancy.

“Even within those two categories, there are multiple options,” said Dr. Honken. “There are five versions of the IUD, including a type that contains copper, and four IUDs that release low-dose progesterone, a hormone that prevents the body from becoming pregnant.”

Who is a good candidate for an IUD or another LARC option?

Long-acting reversible contraception is a great option for many individuals looking for a reversible way to prevent pregnancy that doesn’t require daily actions on their own part. It’s often recommended for those who cannot take daily oral birth control due to medical conditions or other reasons.

How effective are IUDs at preventing pregnancy? What about other LARCs?

“LARCs are extremely effective at pregnancy prevention,” said Dr. Honken. “And the best thing about them is that, from the perspective of someone who needs birth control now but wants to carry a pregnancy later on, that there is no lingering effect on fertility, and you can get pregnant shortly after removal.”

In fact, the etonogestrel implant is the most effective contraceptive method on the market, even more than having tubes tied. Just after that in effectiveness are the levonorgestrel IUDs. The copper IUD is the least effective long-acting reversible contraception method, but that is relative to the other LARC options – its 10-year effectiveness is still close to having your tubes tied.

Do IUDs and other LARCs protect against STIs?

Long-acting reversible contraception methods are designed only for pregnancy prevention. They do not protect you from STIs. You will still need to practice safe sex, including using condoms consistently during intercourse, barrier protection during oral sex and by getting tested regularly.

“We also recommend that if you utilize sex toys that you use condoms as well and clean the toys after every use. Practicing mutual monogamy, limiting your number of sex partners and undergoing a simple STI test before having sex with a new partner are all methods to help prevent the spread of and infection with STIs.”

Ask for an STI test to be performed during the same appointment where your LARC is placed, so you can move forward well-informed and well-protected.

How do I know what type of contraception is right for me?

“First off, talk to your doctor,” said Dr. Honken. “You know your body best, but your doctor will know from looking at your medical history if you have any conditions that could cause issues. They can help to guide you based on your future procreative plans and current desires.”

Every type of contraception has risks and benefits, so it’s important to take everything into account when deciding what would be best for you.