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What teens need to know about long-acting reversible contraceptives

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What do you know about implants and IUDs?

When it comes to sexually active teenagers, there's good news and bad news. The good news? Nearly 90 percent of teens ages 15 to 19 report using birth control the last time they had sex. The bad news? Less than 5 percent of those teens used the most effective type of birth control.

According to the CDC, most teens use birth control pills and condoms; methods which are less effective at preventing pregnancy when not used properly. While no birth control is 100 percent effective, long-acting reversible contraceptives (LARC) are pretty dang close—less than one out of 100 women get pregnant each year with this choice. On the flip side, nine out of 100 birth control pill users get pregnant each year, while 18 out of 100 condom-only users conceive a child each year. Blame it on user error—every time you forget to take a pill or your partner puts a condom on wrong, your chance of getting pregnant skyrockets.

That's where LARC comes into play. These "set it and forget it" methods of birth control consist of implants and IUDs. You go to your doctor, have the birth control inserted in your body, and boom! You're protected for the next three to 12 years, depending on the type of LARC you chose.

Implants and IUDs are just as effective as getting your tubes tied or having a vasectomy. There's no daily pill to take, no action required before having intercourse, and a very low rate of complication. And the best part? Once you ARE ready to have children, you go to your doctor, have the birth control removed. It's that easy.

The American College of Obstetricians and Gynecologists (ACOG) recommends LARC methods as the safest, most effective birth control for teens. The ACOG recently published the following statement: "Long-acting reversible contraceptives (LARC) have higher efficacy, higher continuation rates, and higher satisfaction rates compared with short-acting contraceptives among adolescents who choose to use them. Complications of intrauterine devices and contraceptive implants are rare and differ little between adolescents and women, which makes these methods safe for adolescents."

What's the difference between implants and IUDs?

The birth control implant is a tiny, matchstick-sized plastic rod that's placed under the skin of the upper arm. According to the Mayo Clinic, "it releases a low, steady dose of a progestational hormone to thicken cervical mucus and thin the lining of the uterus (endometrium). Contraceptive implants typically suppress ovulation as well."

Nexplanon (the other name for the implant) lasts for up to five years but can be removed at any time. The hormones in the implant prevent pregnancy in two ways. According to Planned Parenthood, "Progestin thickens the mucus on your cervix, which stops sperm from swimming through to your egg. When sperm can't meet up with an egg, pregnancy can't happen. Progestin can also stop eggs from leaving your ovaries (called ovulation), so there's no egg to fertilize. When eggs aren't released, you can't get pregnant."

An IUD (or Intrauterine Device) is a small piece of flexible, T-shaped plastic that's placed inside of your uterus. There are two kinds of IUDs: copper IUDs (ParaGard) and hormonal IUDs (Mirena, Kyleena, Liletta, and Skyla). Both the copper and hormonal IUDs work by changing the way sperm cells move so they can't get to an egg, Planned Parenthood says. If sperm can't get to the egg, you can't get pregnant.

ParaGard contains no hormones, which is an appealing factor to many women. The copper creates a toxic environment for sperm and is proven effective for up to 12 years. The downside? It's known for making periods heavier than usual.

Hormonal IUDs work similarly to the implant: they thicken the cervical mucus to block sperm and stop your body from ovulating. Depending on the type of hormonal IUD you choose, you're protected from pregnancy for three to seven years.

Neither the implant or IUDs protect from sexually transmitted diseases, so always use a condom to protect yourself against infection.

What's the first step?

Have an open and honest conversation with your parents and your doctor to find out if a LARC method is right for you.

This article is for informational purposes only. If you have any concerns about your birth control method or think you may be pregnant, please speak with your doctor.

ACR Health is committed to providing comprehensive, evidence-based sexual health education for teenagers. For more information, call 800-475-2430 or visit www.acrhealth.org/youth/CAPP

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