The primary reason LARC’s are so much more effective than older contraceptive technologies is the default factor - Valerie Tarico


image by: URGE at Mills College

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Picture a Technology Revolution. In Contraception. It’s Here

Imagine a future in which we can simply toggle the default on human fertility, so that accidental pregnancy is a thing of the past and women become fertile only when they want to become pregnant. By nature, adolescence switches our fertility default to “on” and it is stuck there for the next 40 years. Globally, 100 million women want to delay, space or limit child bearing but have no control over their fertility. Even women who are lucky enough to have contraceptives like Pills or patches or injections have to keep switching fertility back off.

The latest generation of long acting reversible contraceptives (LARCs) are game-changers.…

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 Picture a Technology Revolution. In Contraception. It’s Here

Imagine a future in which we can simply toggle the default on human fertility, so that accidental pregnancy is a thing of the past and women become fertile only when they want to become pregnant.

 Which IUD Should You Get?

Insertion is the same with all of them: not comfortable, exactly, but usually manageable. But the devices have different amounts of hormones — or none at all — and will change your periods in different ways. Among the hormonal IUDs, the higher the hormone amount, the more likely it is that your period will stop after six months to a year. Here’s how they compare to each other.


Best for: Women who want more than three years of use, and want to keep menstruating. Skip if: You don’t have the patience to fight with your insurance. Bayer, which manufactures Mirena and Skyla, developed this newest IUD which became available in October. Kyleena is approved for use in women regardless of whether they’ve had kids. It releases fewer hormones than Mirena, but more than Skyla, though it lasts the same amount of time as Mirena. This device might be a better option for women who want five years of pregnancy prevention but would rather get their period than not. In the approval studies, about 12 percent of women stopped getting their periods after one year, and 20 percent did after three years. But beware: If you’re interested in Kyleena, it could be a hassle to get your insurance to pay for it for the next five to six months until the temporary billing code designated for new drugs and devices becomes a permanent one, Dr. MacIsaac says - The Cut


Best for: Women on a budget. Skip if: You don’t want your period to disappear entirely. This device is a pharmacologic equivalent to Mirena (it has the same total amount of hormones), but was developed to be less expensive for women visiting family planning clinics who are either on Medicaid or lack health insurance. It costs providers $50 and they can pass on savings to their patients. It’s not technically a generic because it looks a little different and releases slightly less hormone on a daily basis, though there is the same amount of hormone in the device. Still, about the same number of women reported amenorrhea (no periods) with Liletta as with Mirena (Liletta’s rate is slightly higher after three years). It’s currently approved for three years but the manufacturer will be submitting five-year data to the FDA and will continue to study the same group of women for seven years. It’s possible that Liletta could last even longer than Mirena since the daily release is lower, but only further research can prove that - The Cut


Best for: Women with heavy periods. Skip if: You don’t want your period to disappear entirely. Mirena was initially approved for women who’d already had children, but that’s just because those were the women recruited for the study submitted to the FDA. Doctors prescribe it to women without kids all the time and, in fact, the American College of Obstetricians and Gynecologists has recommended long-acting reversible contraception as the first-line method for adolescents since 2012. Where ParaGard can make periods worse, a hormonal IUD could help improve painful periods — in fact, Mirena is also FDA-approved for the treatment of heavy menstrual bleeding, or menorrhagia. About 20 percent of women with a Mirena see their period stop after a year, as do a third of women who use it longer. Mirena is approved for five years but recent data says it’s effective for seven - The Cut


Best for: Women who like the idea of a smaller IUD. Skip if: You’re looking for a long-term commitment. This device is approved for three years and is specifically marketed to women who haven’t had kids. It’s smaller than Mirena, which makes it more appealing to people who haven’t had their cervix dilated, but we’re talking about the difference of a few millimeters, says Kristyn Brandi, MD, family planning fellow at Boston Medical Center. What is different is that it releases fewer hormones on a daily basis, meaning more women keep getting their periods on Skyla versus with Mirena — which is appealing if you would prefer to keep your normal bodily function intact, Dr. Brandi says. (Only about 6 percent of Skyla users stop getting their period after one year; 12 percent of users stop after three years.) That, and it’s only approved for three years. If you want contraception for longer, you should probably get a different IUD - The Cut


Prescription NuvaRing (etonogestrel/ethinyl estradiol vaginal ring) is a flexible birth control vaginal ring used to prevent pregnancy. Do not use NuvaRing if you smoke cigarettes and are over age 35. Smoking increases your risk of serious heart and blood vessel problems from combination hormonal contraceptives (CHCs) including heart attack, blood clots, or stroke which can be fatal.

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