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So you’ve chosen not to get pregnant, 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 how suitable they are for young women and women who have not had children. “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

Students’ stories

“Getting an IUD is awesome. Though they last for at least five years you can get it taken out at any moment. I have the Mirena, and though it secretes a little bit of progesterone into your body, I experience no side effects and enjoy a more predictable, lighter period. I have recommended it to many friends.”
—Fourth-year student, Montgomery College, Maryland

“I am a new user of the IUD and the only complaint I have is it takes a while for your body to get used to it. Don’t freak out if you’re bleeding/cramping for a week. Friends of mine are so happy with this IUD and it has done away with their periods.”
—Third-year student, University of New Mexico

“I love my IUD! It has made my life so much better. I always hated the way that the Pill messed with my emotions. My non-hormone IUD (ParaGard) is such an amazing alternative. I don’t have the mood swings, it’s not something I have to think or worry about on a daily basis, and my periods are very predictable.”
—Second-year graduate student, Saint Louis University, Missouri

“I dated a girl that used the Mirena IUD and she was very happy with it. She enjoyed not having a monthly period.”
—Third-year student, Northern Maine Community College

“My wife had an implant and it was great. There seemed to be no ill side effects and it was very effective.”
—Online student, Minneapolis College of Art and Design

“Nexplanon is a progestin implant that goes in your arm, about the size of a matchstick. It does hurt and give a nasty bruise for a month, but I haven’t had any weight gain, mood swings, or ill-effects from it. I also have not had any painful ovarian cysts (which I used to get pretty often) since getting the implant. Also, [for me] it makes periods lighter or not happen at all.”
—First-year student, Northeast State Community College, Tennessee

“I have a copper IUD and it’s great. I’d heard that copper IUDs could make periods worse, but mine hasn’t. I switched to a copper IUD after hormonal birth control made me depressed and irritable and killed my sex drive. Now I feel like a normal human being again. Best decision ever.”
—Third-year graduate student, University of Victoria

“The IUD isn’t for everyone. I’m on [the copper IUD] because I can’t have birth control with hormones. The one annoying thing is that my periods have become more frequent.”
—Fourth-year student, Carleton University, Ontario

Is it painful to get an IUD or implant?

Is it painful to get an IUD or implant?
“A lot of people hear stories about IUD insertion being painful or scary. Everybody’s experience is different, and it’s often not as bad as you think it will be. The cramping and scariness go away, but your birth control stays in place. Most patients that I place the IUD in say, ‘Oh, that wasn’t nearly as bad as I thought!’”

“Some women are more comfortable with getting the implant inserted in their arm, because it’s more familiar, like a tattoo or piercing.”

—Dr. Colleen Krajewski, practicing OB-GYN; assistant professor at the University of Pittsburgh Magee-Women’s Hospital, Pennsylvania; medical advisor to Bedsider.org

IUD
“It is an awkward experience to have an IUD placed, and [for me] there were several weeks to months of random spotting. However, there was no pain after the first couple of days, and you don’t have to worry about a daily routine [like taking a pill], which is convenient.”
—First-year graduate student, Idaho State University

“The lady that helped me was very nice and explained it all to me. It hurt when she put it in, but the procedure did not take long. I love the IUD. I got the Mirena, which makes your period go away or lightens it. So now I don’t have to worry about my period every month or about getting pregnant.”
—Third-year student, University of Hawaii at Manoa

“I always had really painful periods and started to have problems with my period becoming irregular. I decided to try a hormonal IUD because I have problems remembering to take pills. I was surprised by how painful the insertion was, and I bled for the entire first month, but now I am so glad I have it! I have a low-dose IUD so I still get periods, but they are very light and my pain is manageable.”
—First-year graduate student, Fanshawe College, Ontario

Implant
“We’ve used the implant and it was a very positive experience. The only issue was getting it inserted, which was fairly uncomfortable for my partner.”
—Second-year graduate student, University of Victoria

“The implant insertion procedure was painless. They numb your arm and then insert the birth control rod. You have to keep your arm wrapped for 24 hours and there will be a bruise for a couple of weeks. The insert is not painful to touch. Other than the initial bruise, your arm will feel normal.”
—Student, Salem College, North Carolina

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

Students: LARCs kept my options open

“I chose a copper IUD because it didn’t contain hormones and I didn’t want to worry about it affecting my mood. I loved that it was easily removed and that I was able to get pregnant soon after having it removed.”
—Third-year student, Portland State University, Oregon

“My girlfriend/sexual partner had an implant called the Implanon that was successful for her. She recently had it removed to donate her eggs to a family trying to get pregnant.”
—Fifth-year student, Cape Cod Community College, Massachusetts

“My doctor recommended the Mirena IUD, and I am so happy I decided to try it. I did experience some mild cramping for the first 24 hours, but after that I didn’t even notice it was there. My favorite part is I know I can control when I want to start a family, which is important being a vet student!”
—Second-year graduate student, Ontario Veterinary College, University of Guelph

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

Students: Here’s what makes it easy

“I had a five-year IUD placed. Best decision I made. My gynecologist had a vast knowledge on the product and the risk and benefits for someone my age. I didn’t have any problems, health-wise, and I didn’t have to remember to take a pill. It was a win-win situation.”
—Fourth-year student, University of Miami School of Nursing and Health Science

“I started out with the birth control shot [an injection that protects against pregnancy for three months] but found that I was too busy to remember to go every three months. My doctor recommended the implant. She said it was convenient and a one-time insertion and would last for three years, worry-free. Why not? It was very effective and very convenient. You don’t need reminders or alarms to tell you to take a pill or change a patch or switch a ring.”
—Student, University of Wisconsin–Manitowoc

“When I switched from a diaphragm to an IUD I was really happy. Things could be more spontaneous with my partner and I didn’t have to worry about taking the diaphragm and spermicidal jelly with me on trips, running out of that jelly, or damaging the diaphragm.”
—First-year student, Central New Mexico Community College

“The IUD is less of a hassle. After your body adjusts (1–3 months, depending on your body), you forget it’s there.”
—Second-year student, College of the Desert, California

“I was in a long-term relationship and [she] used the implant. It helps give you peace of mind.”
—Fourth-year graduate student, Park University, Missouri

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.

Students’ stories
“I have Nexplanon (the implant). Got it for free through a nonprofit. Works like a charm so far.”
—Fifth-year undergraduate, University of Memphis, Tennessee

“I got my IUD the summer before I started college. I went to my city’s women’s health services clinic and got it for free.”
—Third-year undergraduate, University of Hawaii at Manoa

“The IUD was a great alternative to the pill. It [can be] expensive if health insurance doesn’t cover it though.”
—Graduate student, University of Alaska, Anchorage

+ 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

Students: Why we use condoms too

IUDs and implants do not protect you against sexually transmitted infections (STIs). To protect your sexual health, you still need to use safer-sex methods, such as condoms and latex dams.

“I have Mirena (a hormonal IUD) and I have found it to be extremely helpful. I still use condoms to protect [me and my partner] from sexually transmitted diseases.”
—Second-year student, Westfield State University, Massachusetts

“Condoms are [98 percent] effective as [a] form of birth control [with perfect use], and are effective against STIs.” [With typical use, male condoms are 82 percent effective at preventing pregnancy, according to Bedsider.org.]
—Third-year graduate student, college withheld

“Both my primary care physician and my partner’s PCP recommend using both a condom and [birth control] to ensure safer sex practices. We are not looking to have children yet and therefore choose to
be extra careful.”
—Second-year graduate student, Westfield State University, Massachusetts

“Me and my partner use both condoms and birth control. Also, she uses birth control for other non-contraceptive reasons.”
—Fourth-year student, University of Waterloo

+ 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

+ Download on the App Store

+ Get it on Google Play

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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.