Let’s talk about Nexplanon, IUDs, & Permanent Birth Control!
The Implant (Nexplanon)- an implantable rod that is placed under the skin in the upper arm. It contains only progesterone which is released slowly over time. It is FDA approved for 3 years but may be effective for as long as 5 years. It is placed in the office under local anesthesia (lidocaine). This method is ONE OF THE MOST EFFECTIVE forms of birth control available. It can be removed any time after insertion, you are not required to keep it for a certain amount of time.
Pros: essentially no user error, this method is a set-it-and-forget-it option. It does not require a pelvic exam for insertion. There are essentially no medications that will reduce its effectiveness.
Cons: mild discomfort with the insertion procedure. It does require an office visit to place the device as well as an office visit to remove the device. The most common side effect is irregular bleeding.
The IUD (Mirena, Liletta, Kyleena, Paragard)- Ask any gynecologist what their favorite (and likely personal) method of birth control is and 90% are likely to say the IUD (in particular, a progesterone-containing IUD). This is because IUDs are ONE OF THE MOST EFFECTIVE forms of birth control and have the lowest rate of side effects of all available methods. IUD stands for Intrauterine Device. It a small, T-shaped device that is placed in the uterus during a pelvic exam in the office. The progesterone-containing IUDs release the progesterone slowly over time and are effective anywhere from 5-7 years depending on the device. The copper-containing IUD (Paragard) does not contain any hormones as is a good option for patients who cannot or do not want to use hormones. Paragard is effective for up to 10 years. The device can be removed at any time.
Pros: all IUDs are highly effective and have one of the lowest rates of failure (the chance of pregnancy with an IUD In place is 0.8%). They are another set-it-and-forget-it method and do not require the user to manage them in any way after placement. The progesterone-containing IUDs often result in lighter, shorter periods and for some women, their period may stop altogether which is considered a big bonus for most of us! Many women use a progesterone IUD to control their heavy, painful periods. Both types of IUDs have the quickest return to fertility after discontinuing all forms of birth control.
Cons: IUDs do require a pelvic exam for insertion and removal. The insertion can cause some discomfort. Complications of the IUD are extremely rare- less than 1% of users will experience an IUD perforation. Paragard users may notice their periods become a little heavier and more painful. Progesterone IUD users can have irregular bleeding which is most common in the first 3-6 months after insertion.
Myths: unfortunately, due to complications associated with prior IUDs which are no longer available the IUD has gotten a bad rap. Infections related to the currently used IUDs are very rare. The IUD will NOT cause infertility or increase the likelihood of a pelvic infection. IUDs can be used by anyone with a uterus including those who have not had a baby. It can even be used by people who have not yet started having sex! It is extremely uncommon for the IUD to move outside the uterus.
Sterilization (tubal ligation, vasectomy)– these methods of birth control are considered permanent and thus should only be considered by those who are CERTAIN they do not want any or more children. For tubal ligations, we now recommend complete removal of both tubes as this will reduce the risk for ovarian cancer. It is still an option to have only a portion of the tubes removed or cauterized. Our office does offer sterilization for women who are childfree and wish to remain that way.
Pros: hormone-free, no chance of reduced efficacy from other medications, no user error.
Cons: require a surgical procedure which for tubal ligation is more invasive and requires general anesthesia compared to vasectomy. Considered permanent. While reversal is technically possible for both tubal ligation (unless both tubes are removed) and vasectomy it should be noted reversal would not be guaranteed to work. Also, most insurances will not pay for a reversal procedure.
Myths: having a tubal ligation WILL NOT change your hormones. Hormones are released by the ovaries which are not altered by tubal ligation. The change some women notice in their periods after having a tubal ligation is most often due to no longer using hormonal birth control and thus losing the benefit of light, short periods which are beneficial side effects of hormonal birth control.
Hopefully, this post has given you a starting point in your search for safe, effective contraception. By no means did I cover all there is to know about this topic. The choice of a birth control method is highly individualized. I encourage you to call our office to schedule a consult with one of our expert physicians. We are here to help you find the best method for YOU!
We are accepting new patients! To schedule an appointment with OBGYN Associates, call us at 515-288-3287.
DISCLAIMER: All information on this website is provided for informational purposes only and is not intended to be construed as medical advice. OBGYN Associates shall not be liable for any errors or inaccuracies contained herein, or any actions taken in reliance thereon.