Long-Term Contraception

Intrauterine Contraception (IUC):

For women who are interested in convenient long-term contraception (5 or 10 years), intrauterine contraception is an option.  This is commonly referred to as an IUD (intrauterine device).  There are two types of IUDs available in the U. S.  Both are over 99% effective at preventing pregnancy.  However if pregnancy does occur, there is an increased risk of ectopic pregnancy, or a pregnancy outside of the womb.

Scientists believe that IUDs work in many ways, not all of which are fully understood.  They work mainly by interfering with fertilization of the egg.  There are other differences between the two IUDs available that enhance their effectiveness.

For both types of IUDs, insertion is similar.  It is done in the office and can cause cramping, bleeding and dizziness.  Usually over the counter medicines such as Advil or Aleve can reduce any discomfort.

Risks of inserting an IUD are bleeding, infection, uterine perforation, where the IUD goes through the uterus, and finally expulsion.  Except for bleeding, these risks are rare.  It is not uncommon for women to experience irregular bleeding for up to 12 weeks after insertion.

It is recommended that people who have an IUD inserted return after one month to confirm the IUD is still in place.

IUDs can be inserted in both women who have and have not had children.  Talk with our providers to determine if an IUD is right for you.

***For women with certain types of cancer, uterine anomalies, or undiagnosed abnormal uterine bleeding, the IUD is not appropriate.

***The IUD does not protect against STDs.

Mirena IUD

This IUD is now FDA approved for long-term contraception as well as control of heavy menstrual bleeding.  It is a small, flexible device that is inserted in the office and provides contraception for up to 5 years and has been used for contraception in the U. S. since 1999.

A very small amount of progesterone (levonorgestrol) is released and acts at the level of the uterine lining to keep it thin resulting in lighter periods.  Twenty to thirty percent of women after one year of the Mirena insertion report amenorrhea, or no periods.  This is safe and is an expected outcome.


Paraguard IUD

This IUD provides up to 10 years of contraception and has been FDA approved for over 20 years.  It is non hormonal which is appealing to many women.  It is has a flexible T shape that is coated with copper that is believed to kill sperm cells.  Heavier periods have been recognized as a possible side effect.  There are a few contraindications for its use specific to Paraguard that you should discuss with your healthcare provider.



is a long-acting prescription contraceptive that lasts for up to three years. IMPLANON contains a progestin only hormone. Because it doesn’t contain estrogen, your healthcare provider may recommend IMPLANON even if you cannot – or don’t want to – use estrogen.

IMPLANON is more than 99% effective at preventing pregnancy, which means that there is less than one pregnancy per 100 women who use IMPLANON for one year. It is not known if IMPLANON is as effective in very overweight women because clinical studies did not include many overweight women. IMPLANON must be removed by the end of the third year and may be replaced with a new IMPLANON at the time of removal, if continued contraceptive protection is desired. Your healthcare provider can remove IMPLANON at any time. If you decide you want to become pregnant, the ability to become pregnant usually returns quickly after your healthcare provider successfully removes IMPLANON. Some women have even become pregnant within days of having the contraceptive removed.

After removal, if you don’t want to become pregnant, you should start another birth control method right away. Tell your healthcare provider about any medications you are taking, or intend to take, including over-the-counter medicines, herbal medicines and prescription medicines. Certain medicines may make IMPLANON less effective, and you may also need to use a barrier method of contraception as backup.