Is long-term contraception right for you?

Finding the birth control option that suits you best can take time. Women often first consider the pill but long-term contraception (LARC) such as an Intra Uterine Device (IUD) or the Jadelle implant are great options. In this article, Dr Suyin Kuor explains why Long Acting Reversible Contraceptives (LARCs) is worth considering. 

What is long-acting reversible contraception? (and why it might it suit you)

Long-acting reversible contraception, or LARC, is a very effective, practical and convenient form of birth control.  When Jade, 25, came to see me, she summed up one of the frustrations of having to take a daily contraceptive pill: “After a couple of years on the pill, I became aware that having to remember to take the pill everyday wasn’t working for me. Working shifts, it just wasn’t that easy to take it at the same time each day. So, I was getting a bit anxious at the end of some cycles that I wasn’t fully protected.” 

In Jade’s case, the decision to change to a LARC was straightforward. “Because my IUD releases the hormones automatically, I felt a real sense of freedom to get on with my day-to-day life. Remembering to take birth control pills became a thing of the past, and I felt more relaxed being intimate with my partner ,” said Jade.

Getting started on your research of whether a LARC is right for you requires first knowing what options are on the market and which might best suit you.

 There are a few different forms of long-term contraception, including:

• Jadelle implants
• Hormonal intrauterine device (Mirena)
• Copper intrauterine device

Jadelle Implant

• ‘The rods,’ as commonly referred to, tends to be effective for approximately 3-5 years. 
• The Jadelle Implant is constructed of two small rods, roughly the size of a needle. 
• When the rod is implanted, it will be placed just under the skin of the bicep on your arm. 
• Once inside your arm, a hormone called progestogen will slowly be released, stopping you from getting pregnant.  

Hormonal IUD

• Hormonal IUDs is a miniature t-shaped object that your doctor will insert into your uterus. 
• Like the Jadelle implant, the hormonal IUD contains a progestogen hormone. 
• In most instances, after a few months have passed, your periods will lessen or disappear due to the insertion of the Hormonal IUD. 
• Therefore, this may be your best option if you get heavy or painful periods. 

Copper IUD

• Copper IUDs look and feel the same as hormonal IUDs. 
• The only exception is that the Copper IUD does not contain any hormones. Hence, this may be a good option if you wish to steer clear of hormones.
• By preventing the sperm from getting to the egg, a Copper IUD is extremely effective.

Why LARCs might be best for you.

There are many reasons why I end up having conversations with women about LARCs. It all depends on their life stage and where they are at in their family planning. But IUDs can also be helpful for people who have experienced heavy or painful periods. It’s not just about birth control.

Nonetheless, long-acting reversible contraception is the most effective form of birth control, with a 99% effectiveness against pregnancy. This means that only 1 in every 100 women will get pregnant every year. 

And of course, LARCs are very useful if you find yourself forgetting to take your birth control pill. When you receive long-term contraception, whether it be the Jadelle implant or an IUD, you can completely forget about it for the next few years. You will not need to stress about remembering to take a pill every day. Moreover, if you receive your long-acting reversible contraception from Botany Junction Medical, we will contact you when it is time to get it removed or replaced. Thus you do not need to worry about remembering it yourself. 

But the feedback most women give is that they love having options that have less estrogen than traditional Pill based contraception.

“Funnily enough, after about six months of having a Mirena IUD, I found I was feeling a bit calmer. My partner says I seem less anxious when I’m nearing my period. But also, I have a much lighter flow which is a real bonus”, says Jade.

I’d be remiss not to mention that despite the freedom LARCs can offer you, they do not protect against Sexually Transmitted Infections (STIs). So, if you aren’t in a monogamous relationship, you’ll still need to use a condom when having sexual intercourse.

How do I decide which option is best for me?

We have made the process for LARC discussions an easy and accessible option for all our patients. To do so, all you have to do is call our reception team or leave a message with our nurses, informing them you would like an appointment to discuss long-term contraception. A trained nurse from our Women’s Health Clinic will contact you back within a few days to arrange an initial appointment to discuss the best option for you, then we will book a suitable time for the insertion.

When deciding the most suitable LARC for you, we will take into consideration the following:

• Your age
• Medical history
• Personal preference

Since every woman is different, it is essential for us to have a good understanding of your medical history. This allows us to make an informed decision about which option will be the safest and most effective for you. For this reason, we recommend that you book with us to have this assessment, as we are familiar with your medical history. This whole process is confidential, and records will not be shared with your family members. 

Please note that it is important that you are not pregnant when we insert the LARC. We ask that you use an alternate source of contraception e.g. condoms, for a period of time prior to the procedure and will discuss this with you at your initial appointment.

What does it feel like getting a Jadelle or IUD implant? (and why it’s called the Fit and forget contraception!)

We will inform you of the process of insertion when we have agreed on the best option for you. In most instances, these are quick and easy procedures that will only take a few minutes in your day. It is completely normal for you to experience some pain whilst having your Jadelle Implant or IUD inserted. We will give you medication to help with the pain. It is not uncommon to feel a bit uncomfortable after the procedure, so we recommend that you take it easy for the rest of the day.

“Having my Mirena IUD fit was pretty fast, but I needed the quiet afternoon I’d been advised to set aside. That’s mainly because I had some spotting and some cramping. But, from then on in, my periods have been so easy, it was totally worth it.” says Jade.

Long-acting reversible contraception is often called the ‘fit & forget’ method, as you can forget about it just after your GP has completed the insertion. Roughly 3-5 years later, depending on the long-term contraceptive you were given, your GP will contact you about booking an appointment to remove or replace your long-term contraception. In the meantime, we encourage you to get a cervical smear if you’re over the age of 25 to ensure your cervical health. 

At Botany Junction Medical, we have a select number of staff members who’re credentialled for the insertion and removal of long-term contraception that you can book an appointment with:

• Suyin Kuor
• Jayani Kannangara
• Therese Khella
• Nurse Rashika Devi