Hormonal contraceptives offer women of all age’s protection against unintended pregnancies through suppression of ovulation, thinning of the uterine endometrium, and/or inhibition of sperm motility and decreased sperm dispersion through the cervical canal and into the ovum. Many reliable, effective, and safe contraceptives are available for women, including long-acting reversible contraception (LARC) for women who are not candidates for estrogen-containing birth control or who prefer continuous protection for extended intervals.
Hormonal IUCs release progestin, a synthetic version of the hormone progesterone. The levonorgestrel impregnated IUC releases progestin into the uterine cavity, thickening cervical mucous, and causing thinning of the lining of the endometrium. There are four approved devices in the U.S., to include the Mirena, Kyleena, Skyla and Liletta. These are small, plastic, T-shaped contraceptives, that are placed inside the uterus and prevent pregnancy more than 99% of the time. The progestin IUCs start working about seven days after insertion and may be left in place, depending on the type, from three to seven years. All are inserted by a trained healthcare professional and can easily be removed at any time. At RWWC, we currently have both the Liletta and the Kyleena.
Liletta slowly releases 52 mg of a progestin hormone called levonorgestrel. This is the same kind of hormone that is often used in birth control pills. Only a small amount of levonorgestrel enters your bloodstream. Neither the Liletta nor the Kyleena contain estrogen. Approved for use in the U.S. in 2015, it measures 32 mm x 32 mm. Kyleena, approved in 2016, contains 19.5 mg of levonorgestrel and measures 28 mm x 30 mm. It works the same way as the other progestin containing IUCs, slowly releasing levonorgestrel over time. Both are effective against unintended pregnancies for up to five years.
The Copper-T 380A IUD (intrauterine device) was introduced into the United States in the late 1980’s. It is a small, (36mm vertically x 32mm horizontally) plastic “T” shaped contraceptive placed in the uterus by a trained health care professional. The approved duration for use of the Copper IUC is twelve years. Otherwise known by the brand name Paragard, this IUC is the only nonhormonal IUC approved for use in the U.S. Paragard does not contain hormones, instead using the copper that surrounds it to halt sperm from getting to the egg as well as possibly creating an immune response within the reproductive tract that interferes with fertility before an egg reaches the uterus. IUCs prevent fertilization but are not abortifacients, which had been a common myth. The Paragard IUC works as soon as it is placed inside the uterus and can be used for emergency contraception if inserted within five days after unprotected intercourse. The Paragard is easily removed whenever you want and is safe to use while breastfeeding. Common side effects after placement include heavier periods and cramping for several months, both alleviated with over the counter non-steroidal anti-inflammatories (NSAIDs) like ibuprofen. We do offer the Paragard IUC at RWWC.
Hormonal contraception also offers many health benefits besides prevention of an unintended pregnancy. The hormonal intrauterine contraceptive (IUC) may reduce the risk of some cancers, including cancer of the endometrium (the lining of the uterus), cervical, ovarian, and even colon cancer. Many women benefit from menstrual regulation and decreased cramping, while others have a lighter period-or no period at all. Both the hormonal and non-hormonal IUCs are over 99 percent effective, cost-effective, long-lasting, and decrease the possibility of user error that comes with taking a pill every day or using condoms.
There are a few risks involved with the IUCs, as well as contraindications, that should be discussed with your healthcare provider prior to insertion. Please schedule a consult beforehand, if you have not already discussed the appropriateness of IUCs at your annual gynecologic visit. Problems can be managed, and most women are happy with their choice. Continuation rates for intrauterine contraceptives are generally higher vs. other forms of contraception for women.
We also offer Nexplanon. The Nexplanon is considered a contraceptive implant – it is a very small rod inserted under the skin of a woman’s upper arm to provide birth control. It’s invisible and prevents pregnancy for up to 4 years.