LARCs: FAQs About Long-Acting, Reversible Contraceptives.
Starting with… what the heck is a LARC?
Long-Acting Reversible Contraceptives (whew, it’s a mouthful) are birth control methods that last for years, are super effective, and require no action whatsoever aside from insertion and removal. It’s basically a long-term relationship with your birth control (that you can break up with whenever you please, because they can be removed anytime!).There’s a lot to learn about these little devices, so here are the answers to some frequently asked questions about LARCs.
1. What are the different kinds of LARCs?
LARCs include IUDs (intrauterine devices) such as the Paragard, Mirena, Kyleena, Liletta, and Skyla (Bridgercare carries the first four). IUDs are small, T-shaped objects that are inserted into your uterus by a medical provider. It sits inside the uterus until you decide to remove it. Sometimes people think that your IUD goes into your cervix, but it actually is inserted through the cervix into the uterus. Only the IUD strings stay hanging through the cervix, not the main part of the device. There’s also the Nexplanon implant, which is a little rod about the size of matchstick that’s inserted into your upper arm.
2. How long does an IUD last?
LARCs, like IUDs, are effective for 5 to 10 years, depending on the device you choose. The Kyleena does the job for 5 years, the Mirena lasts for 7 years, and the Paragard works for up to 12!
3. How long does Nexplanon last?
Nexplanon lasts for up to five years!
4. Ok, so that’s a while. How on earth do they work for so long?
Hormonal IUDs and the Nexplanon work by releasing small amounts of the hormone progestin, which prevents pregnancy by thickening the cervical mucus so that the sperm cannot reach the egg. The Paragard is the only nonhormonal LARC. It’s made of copper, which is safe for humans – but it’s sperm’s worst enemy, and works as a spermicide.
5. How effective are LARCs exactly?
Both the IUD and the implant are over 99% effective. And the best part is that there is no room for operator error in using these birth control methods— it’s a “set it and forget it!” situation.
6. Can you feel an IUD? That’d be weird.
Nope! Once the IUD has been placed in your uterus, you won’t be able to tell it’s there. However, you may be able to check if your IUD is still in place by feeling for the strings (you won’t feel them all the time, just when you reach to check them). When your IUD is placed, the provider should cut them to hang about 2-3 centimeters past the cervix. If you’re wondering how to check IUD strings, some people can feel the strings with their fingers and like to check them, but it’s not necessary and it can be difficult for most people to feel them. As time passes, it’s not uncommon for the IUD strings to soften and curl around the cervix so that it hard or impossible to feel them. This is normal, and no reason to panic! Your provider will make sure placement looks good during your annual wellness exams, and you can always come into Bridgercare specifically for an IUD Check visit.
7. Can you use tampons with an IUD?
In short, yes! IUDs are guided through the vagina and cervix and placed into the uterus, where they remain for the duration of the time you have them. Tampons are placed into the vagina, and therefore do not affect your IUD.
8. What are the side effects of an IUD or implant?
For hormonal IUDs and implants, common side effects include lighter, shorter periods, less cramping, spotting between periods and irregular bleeding. Some people even stop having periods altogether, which is a normal and desired effect for many people. The Paragard (the copper IUD) is different—side effects can include cramping and heavier, longer periods.
9. How do you know if your IUD is working?!
If you can feel the strings and your IUD is in place, it is working! However, if your strings are a different length than before or you are experiencing unusually heavy bleeding, or intense, unusual or persistent pain with sex, your IUD may have shifted locations, which can decrease effectiveness. In that case, you should see a healthcare professional.
10. So where can you get a LARC?
An IUD or implant must be placed by a healthcare provider, and you can get them at Bridgercare (who’d of thunk? ?) or another OB/GYN office or health center near you.
11. Can you remove an IUD or implant yourself?
No, they need to be removed by a medical professional. Conveniently, if you wish to continue using an IUD after the 3-10 year time limit, it is possible to remove an IUD or implant and have a new one placed in the same visit.
12. What are the side effects of IUD or implant removal?
There can be brief cramping with IUD removal, and bruising/soreness to the arm when an implant is removed. The main side effect is that fertility returns as soon as the device is removed—in fact, it’s possible to get pregnant even before your next period, so be sure to use another method starting right away if you wish to avoid pregnancy. You may also feel some cramping or bleeding. Additionally, any side effects that you experienced with the LARC will disappear.
13. If I have sex with someone who has a penis, will they be able to feel an IUD?
Unless the IUD is coming out and your partner is feeling the hard, plastic end of the IUD, there is no way that your partner would be able to feel the IUD itself. This is because it sits in the uterus, not the vagina. However, there is a small chance that they may feel the strings of the IUD. If it is bothersome, you have a couple of options—the strings often soften after the IUD has been in place for a few months, but if it is still an issue your provider may be able to cut the strings shorter.
14. How can I afford it?
I heard they can be preeetty pricy. Although the sticker prices of IUDs and implants are very intimidating, you should not let this discourage you. If you have insurance, they are often completely free or low cost. If you’re uninsured, Bridgercare can help you enroll in free programs that cover LARCs or may slide costs on the sliding fee scale. You have options, and Bridgercare will work with you to make sure you can access the birth control of your choice!
15. What should I expect for my IUD or implant insertion?
How should I prepare? For either kind of LARC, you should expect the insertion appointment to last about 30 minutes. A pregnancy test will be done the day of the appointment to make sure that you’re not pregnant, so there can’t have been unprotected intercourse for 2 weeks prior. For the implant, the provider will inject a small amount of numbing medicine into a small area of your arm before the insertion. Before an IUD insertion appointment, it is a good idea to drink plenty of fluids, eat a small meal, and take up to 800 milligrams of ibuprofen to reduce pain during the insertion. It is also a good idea to have someone available to drive you home from the appointment.
16. Should my partner and I still use condoms or dental dams if I have a LARC?
Although LARCs are incredibly effective at preventing pregnancy, they do not protect against STIs. If STIs are still a concern (as with any new partner or before both you and your monogamous partner have both been tested), using a barrier method such as condoms or dental dams is absolutely the way to go! Additionally, hormonal IUDs take one week to become effective, so condoms are necessary for the first week after insertion to avoid pregnancy.
17. Can you get an IUD if you don’t have kids?
Yes! This is a very common myth, but IUDs are perfectly safe and effective for people who have not had children.
18. I’ve heard if you get an implant or IUD you can’t pregnant in the future. Is that true?
Not at all! For both the implant and the IUD, it is possible to get pregnant as soon as they are removed. They are truly reversible at any time! This certainly wasn’t an exhaustive list of good ol’ FAQs, and there’s plenty more to know about LARCs. If you have any questions or are considering getting an IUD or implant (or any kind of birth control, for that matter!), you can schedule with Bridgercare for a birth control consultation or LARC insert appointment. Bridgercare offers many kinds of birth control, and our providers would love to help you find the method that works best for you.
Call (406) 587-0681 to book an appointment today.
Written by Ava Snow, Bridgercare Summer Intern 2019 *UPDATED APRIL 2023