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Long-lasting Contraceptives

By Susan Peck, MSN, APN

Long-lasting Contraceptives

Finally, women have another long-acting reversible contraceptive (LARC) option. For the first time in 12 years, the FDA has approved a new intrauterine device (IUD), Skyla—and the implant is growing in popularity.

What LARCs Do For You

While the pill may be the most commonly used contraception, there are many great reasons to consider a LARC. IUDs are safe, highly effective choices for most women. In fact, the American College of Obstetricians & Gynecologists recommends them as first choice for contraception.
Perhaps more importantly, they’re the “forgettable” contraceptive. Unlike daily, weekly, or monthly methods, IUDs are inserted and only require minimal attention. This makes avoiding pregnancy or spacing your pregnancies much easier. Lastly, when used for at least 2.5 years, IUDs are a cheaper to use compared to other contraceptives.

Choosing an IUD

Currently, 3 IUD are available for use:

1.The Copper T380, Paragard, has been used in the US since 1989. It is a non-hormonal plastic copper-containing IUD approved for women who have or haven’t had children for up to 10 years. It prevents pregnancy by inhibiting sperm and ovum (egg) migration and is spermicidal.

2.The levonorgestrel IUD, Mirena, has been available since 2000. It’s a synthetic progestin hormone that is FDA-approved only for women who have had a child (although many providers believe in the safety of the device and will offer it to women who haven’t had children). It’s effective for 5 years and prevents pregnancy like the Copper IUD, but also thickens cervical mucus, thereby inhibiting pregnancy.

3.The newest levonorgestrel containing IUD is Skyla, recently approved for use in January 2013 for women who have or haven’t had a child and is effective for 3 years. It prevents pregnancy in the same way as Mirena, and overall it’s smaller and shorter acting. Women who haven’t been pregnant may have a smaller uterus, which means Skyla may provide a more comfortable insertion. It’s also an excellent choice for women who may not want to wear it for more than a few years.

LARC should be considered a safe choice for all childbearing women. Using LARC, such as one of these IUDs, provides women with the power to easily control if, when, and how often pregnancy is desired.

IUD Choices

IUDDuration Of UseHormonalCommon Side Effects
Copper T380 Paragard10 yearsNoLonger, heavier perios
Levonorgestrel IUD 52mg Mirena5 yearsYes, progestin onlyShorter, lighter, often irregular bleeding
Levonorgestrel IUD 13.5mg Skyla3yearsYes, progestin onlyShorter, lighter, often irregular bleeding

Susan Peck, MSN, AP, is a women’s health nurse practitioner and an expert advisor to Healthy Mom&Baby in a busy OB/GYN practice in New Jersey.

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