Johns Hopkins All Children's Hospital

Long-acting Reversible Contraception

Information about Intrauterine devices (IUDs) and Implants 

Intrauterine devices (IUDs) and Implants, known as long-acting reversible contraception (LARC), are the most effective types of birth control for teens. LARC is safe to use, does not require taking a pill each day and can prevent pregnancy for 3–10 years depending on the method. Less than 1% of LARC users become pregnant during the first year of use. 

How Does LARC Work? 

  • IUDs and Implants contain a single hormone called Progesterone that is slowly released into the body over 3–5 years. 
  • Copper IUDs do not contain any hormone and slowly release copper into the body for 10 years. 

Who Will Benefit From LARC? 

  • If you have heavy periods and/or cramping.
  • If you are seeking menstrual suppression. 
  • If you are seeking the most effective form of pregnancy prevention. 

Condoms should always be used along with the preferred birth control to protect against sexually transmitted diseases.

Implant

How is it placed?

A trained provider will use a device that will eject a thin flexible rod under the skin near your bicep muscle of either arm. 

Will this be noticeable or uncomfortable under my skin? 

You should be able to feel for it, but it shouldn't bother you or be noticeable to others.

What happens after insertion?

Many will have irregular bleeding that may last longer than six months. After three years, your doctor will make a very small incision in the skin to remove it. 

What are the risk factors?

There is a rare risk of implant moving out of place or infection during insertion or removal.

IUD 

How is it placed?

A trained provider will do a pelvic exam to make sure you're a good candidate and then use an applicator to place the IUD through the vagina and into the uterus. 

How long does it take to place?

5–15 minutes. Most time is spent setting up and making sure you're comfortable! 

Is it painful?

Most teens tolerate this process very well, with some minimal to moderate cramping at insertion and the following day. 

What happens after insertion?

The Progesterone IUD lasts 3–5 years. You may have irregular spotting, which usually improves after 3–6 months. Many people will stop having a period, which is safe. The Copper IUD lasts 10 years. Your doctor may schedule a follow up after insertion. 

What are the risk factors?

The IUD falling out or uterine injury are very rare risks. 

Does it increase my risk of STIs (sexually transmitted infection)?

There is no higher risk with an IUD, but doctors will want to make sure you don’t have a current infection before placement. Remember, the IUD is 99.7% effective at preventing pregnancy, but does not protect against STIs. 

Trained LARC providers include: 

  • Gynecologists
  • Some adolescent providers
  • Health department 
  • Planned Parenthood 

How effective is LARC at preventing pregnancy compared with other birth control commonly used by teens? 

More Effective

Implant
How to use it:

  • Placed by healthcare provider
  • Lasts 3 years

Chance of getting pregnant: <1 in 100*

IUD
How to use it:

  • Placed by health care provider
  • Copper IUD lasts up to 10 years
  • Progesterone IUD lasts 1–3 years

Chance of getting pregnant: <1 in 100*

Less Effective

Pill
How to use it:

  • Take at the same time each day

Chance of getting pregnant: 9 out 100*

Male condom
How to use it:

  • Use correctly every time during sex

Chance of getting pregnant: 18 out 100*
 
*Number of pregnancies per 100 women using the method within the first year of typical use
Source: CDC.gov

To learn more about LARC:

Planned Parenthood - Birth Control
American Academy of Pediatrics 
 

Still have questions? Come see us.

Our adolescent medicine team has special training to meet the unique needs of teens. We're here to help guide you and answer any questions you might have.

The information here is not intended to be nor should be used as a substitute for medical evaluation or treatment by a health care professional. Before using any medical treatment or advice, readers should consult their own professional resources or their personal physician to determine the appropriateness of the medical information for the reader. This publication is for information purposes only and the reader assumes all associated risks.

Created by Kelleen Boehlke, M.D., and Jasmine M. Reese, M.D., M.P.H.

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