LARC, dispelling the myths

Long-acting reversible contraceptives (LARC) are methods of birth control that provide effective contraception for an extended period of time without requiring user action. There are two LARC methods: the IUD and the subdermal contraceptive implant.

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While not currently the leading choice among women, LARC use has been on the rise in recent years.

LARC methods have several important strengths: they are more than 99% effective at preventing pregnancy; can provide protection for up to 10 years; do not require women to remember to use every day or every time they have sex and are cost effective (typically LARC users can save thousands of dollars over a 5 year period compared to the use of condoms and birth control pills).

Despite great evidence-based information about LARC, there are still some myths and misconceptions, even on the part of health care providers. In a 2012 study, researchers from the CDC showed that nearly one third of healthcare providers had misconceptions about the safety of IUDs especially for women who have never had children. Such concerns are misplaced and reality is that IUDs can be a suitable choice for women of all reproductive ages including young women who haven’t had children.

Another concern is the effect these methods can have in future fertility. Implants and IUDs are immediately reversible on removal and many studies have found no difference in pregnancy rates or time to pregnancy between former IUD users and users of other contraceptive methods.

Another fear among patients is the effect of amenorrhea or not having periods with the hormonal implant and medicated IUDs (progesterone IUDs). I perfectly understand how strange and unnatural can feel not having a period. However, the reality is that menstrual suppression as a result of hormonal therapies carries no health risks.

So with all the benefits mentioned and having addressed all the myths and misconceptions, why is LARC not a more popular choice?

One reason is the large upfront cost (cost can not be spread over time) and the second reason is that both methods must be inserted, and removed, by a physician. However, under the Affordable Care Act, ” all insurance plans” in the health insurance market must cover all FDA-approved contraceptive methods prescribed by a physician, including LARC.

The American College of Obstetrics and Gynecology along with the American Academy of Pediatrician, the CDC and WHO have recognized the potential impact of LARC to reduce unintended pregnancies and recommend LARC methods be offered as first line birth control for most women, including adolescents and women who have never had children.

For more information about this topic or help you decide on the method is right for you contact Evelyn Zeda, MD at 939-261-2222.

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