Many women spend a lot of mental energy thinking about their birth control, from taking the pill every day, to having condoms on hand, to using a diaphragm correctly. If you’re rethinking your contraception (for yourself or for your teen), there are more birth control options to choose from than ever before. Many of those options fall under the category of long-acting reversible contraceptives, or LARCs.

LARCs are some of the most effective and long-lasting birth control methods, but only 12% of women in the U.S. currently use them. While LARCs have faced some stigma in the past, they are considered safe for women of any age to use, from their first period to their last one.

So, what are LARCs? And what should you know if you or your teen are considering them as a birth control method? We’ve gathered answers to five common questions about LARCs, to help you make informed decisions about the birth control that’s right for you.

1. What are LARCs and how do they work?

Long-acting reversible contraception is a form of birth control that prevents pregnancy for an extended period of time. Each type of LARC works a little differently, but they all disrupt the following processes involved in becoming pregnant:

  • Ovulation (when the ovary releases an egg)
  • Egg fertilization (when sperm reaches the egg)
  • Egg implantation (when a fertilized egg attaches to the uterine wall)

The various forms of LARCs are:

Intrauterine devices (IUDs)

An IUD is a small, T-shaped plastic device inserted into the uterus to prevent pregnancy. IUDs can remain in your uterus for 3-12 years, depending on the kind you choose. There are two categories of IUD: hormonal (which includes Mirena, Skyla, Liletta and Kyleena) and nonhormonal (ParaGard). Hormonal IUDs release small, continuous amounts of the hormone progestin into the uterus, which thickens cervical mucus and keeps sperm from reaching the egg. It also prevents ovulation and makes it impossible for fertilized eggs to attach to the uterine wall.

The nonhormonal IUD contains no progestin and is instead wrapped in a copper coil. Copper acts as a natural spermicide, preventing sperm from moving through the uterus. It also thins the uterine wall, obstructing egg implantation. Unlike other LARCs, the copper IUD doesn’t interfere with ovulation.

IUD insertion can be completed during an office visit, and usually takes no more than five minutes. It can also be removed at any time. You’ll just need to make an appointment.
Some women may find the IUD insertion process uncomfortable. So, don’t be afraid to talk to your care provider about your pain relief options prior to the procedure.

For more information, check out our blog on IUD birth control.


The birth control implant is a small, thin rod inserted into the underside of your upper, nondominant arm. Commonly known by the brand name Nexplanon, this rod emits the hormone progestin into your body, which causes you to stop ovulating and blocks sperm from the uterus by thickening your cervical mucus. Birth control implants can provide continuous pregnancy prevention for up to five years. Implant insertion is a simple, in-office procedure, and removal can be done at any time.

Contraceptive injections (Depo-Provera)

Contraceptive injections are not quite as long lasting as the IUD or implant, but they can still be considered a form of LARC. Also known by its brand name Depo-Provera, the contraceptive injection is a formulation of the hormone progestin received as a shot. These injections of progestin, typically given in the arm or buttocks, prevent pregnancy by stopping ovulation and blocking sperm from moving through the uterus.

Each contraceptive injection is effective for only about 13 weeks, so you will have to visit your care provider once every three months to get an injection – for up to four injections in a year.

2. Why are LARCs recommended over other types of contraception?

LARCs are more effective at preventing pregnancies than any other form of birth control, with a failure rate of less than 1%. By comparison, the failure rate for condoms is 21%, and up to 9% for birth control pills.

Other advantages of LARCs include:

  • You don’t need to do anything, like remember to take a pill every day, to use LARCs correctly. For this reason, they are the only category of birth control that’s safe to forget about.
  • You can use LARCs year after year. Based on the type of implant or IUD you have, your LARC can last anywhere from 3-12 years. And user satisfaction is high: more than 80% of patients who chose a LARC were still using it a year later.
  • Because LARCs don’t require consistent prescription refills, they can reduce your need for follow-up visits with your doctor and trips to the pharmacy. Aside from the injection, LARC implantations are one-and-done procedures, making them the most time-saving and cost-effective birth control method.
  • Hormone-based LARCs can keep you from getting periods, which many women find very convenient. They can also help relieve the heavy, painful periods and other symptoms associated with endometriosis and polycystic ovarian syndrome (PCOS).
  • IUDs, specifically the Paragard, Mirena and Liletta, are the most effective form of emergency contraception, more effective than even the morning-after pill. If they are placed within five days after unprotected sex, IUDs have more than a 99% success rate of emergency pregnancy prevention.
  • LARCs are easily reversible, and the removal process for the IUD or implant is typically quick and painless. Most women return to full fertility either immediately or just a few weeks after removal of their LARC. Women using the birth control injection may be able to get pregnant 3-4 months after the date of their last shot.
  • You can have an IUD or implant put in right after giving birth and before you go home from the hospital, making LARCs a convenient option for postpartum birth control. Plus, they’re perfectly safe to use while breastfeeding.

3. Do LARCs protect against sexually transmitted diseases?

LARCs don’t provide protection against sexually transmitted diseases (STDs). Male condoms offer the best STD protection.

Studies have shown that women with LARCs are less likely to use condoms because they don’t need them for pregnancy prevention. However, there’s still the risk of getting and spreading STDs. Using condoms in addition to LARCs can provide dual protection during sex.

4. Are LARCs safe for teens?

Yes. LARCs are safe for teens. In the past, LARCs were only offered to women who’d given birth at least once. Now, guidelines from the American College of Obstetrics and Gynecology (ACOG) allow for teenagers who’ve had their first period to choose long-acting reversible contraception as their birth control method. In fact, ACOG recommends that LARCs be the first-line treatment offered to patients of any child-bearing age. And teens in the U.S. don’t need parental permission to get LARCs or any other prescription birth control.

LARCs are an excellent option for busy, always-on-the-go teens, and their increased usage among teenagers has caused a significant decline in rates of teenage pregnancy in the U.S. Unlike many other birth control methods (like the pill), the margin for human error in using LARCs is very small. Even if your teen is not yet sexually active, they may opt for LARCs because of the potential to diminish heavy, painful periods.

While LARCs can be a great birth control method for teenagers, they won’t protect them against STDs. It can be hard to talk to your teen about birth control and safe sex, but if they start using a form of LARC, make sure they know the importance of also using condoms.

5. Are there any risks associated with LARCs?

The risks involved in using LARCs are low, and complications are rare. But it’s still important to be aware of what’s normal and what’s not.

It’s completely normal to experience side effects after insertion of the IUD or implant. You may have some cramping and pain in your lower back or abdomen following the procedure, or tenderness at the implant site, but this should last only a few days. Spotting between periods and irregular periods are also common and typically resolve after 3-6 months, when periods either stop completely or become regular again.

Sometimes, the IUD can move out of place inside the uterus. This is called malposition, and it may cause pain and abnormal bleeding. In very rare cases, the IUD can puncture the wall of the uterus and protrude into the abdominal cavity. This is known as perforation. Careful placement by a health care professional helps avoid these issues. If there are any concerns, an ultrasound can be used to help reassure patients and providers of the IUD location.

Call your health care provider right away if you experience any of the following:

  • The strings at the end of your IUD feel longer or shorter
  • Your implant has moved more than an inch away from its original insertion site
  • You develop shaking, chills or fever in the days following insertion of the IUD or implant
  • You become pregnant with an IUD or implant still present
  • You notice signs of infection (redness, swelling, pain and discharge) at your implant site
  • You have abnormally heavy vaginal bleeding that lasts a long time
  • You feel symptoms of a blood clot (heaviness, throbbing pain, swelling and warmth) in one or both legs

When LARCs are not the best option

LARCs are an excellent birth control method for many people, but they’re not for everyone. LARCs may not be your best birth control option if:

  • You have uterine cancer, breast cancer or untreated cervical cancer
  • You currently have or suspect you may have an STD or pelvic infection
  • You might already be pregnant
  • You experience vaginal bleeding that’s unrelated to your period
  • You have a bleeding disorder or are prone to blood clots
  • You have a copper allergy or Wilson’s disease (if considering the ParaGard IUD)

Don’t worry if LARCs are not for you, or not for you right now. There are plenty of other great options for birth control to discuss with your OB-GYN.

Take the worry out of birth control

From big life changes to simple spontaneity, your birth control should be the last thing on your mind. If you’re ready to stop thinking about birth control, we can help. To learn more about long-acting reversible contraceptives, schedule an OB-GYN appointment.