Personal Experiences of using LARCs

Anne Sexton

Human beings have always tried to control their fertility, and for most of our history contraceptive methods were unreliable at best, and dangerous at worst. Early contraceptives for women were diaphragms or pessaries. These were made from substances as diverse as honey and herbs, rock salt, lily root and — rather disturbingly — elephant dung. It wasn’t until the advent of the contraceptive pill in 1960 that women have had a safe, reliable and easy method of birth control.

The humble pill is not generally seen as one of the crowning achievements of 20th century science. But it should be — it has affected people’s daily lives in a more profound and positive way than some of the flashier technological advances. The pill not only irreversibly altered women’s sex lives and improved their health, it has also allowed couples to plan when and if to have children and how many.

Nobody should doubt the importance of the pill, but in 2016 it is no longer the easiest way of controlling fertility. If taken correctly, the pill is 99 percent effective, but human error means that in practice it often falls far short of that level of reliability. The most exciting development in contraception in modern times has been the number of long-acting reversible contraceptives that are now available.

The name says it all: long-acting reversible contraceptives or LARCs are exactly that — contraceptives that work for a number of years without permanently effecting fertility. LARCs include the hormonal intrauterine system (IUS), the copper coil or intrauterine device (IUD), the injection and the implant. They are convenient, effective and last up to ten years. Many women still chose the pill because it is the best-known contraceptive, or because that’s what they have always used. We spoke to three women using LARCs to get the low-down on their experiences.

The Coil or IUD

Alene (pictured above right) is her early twenties and uses a non-hormonal IUD. These are 99.2 percent effective. There are different types of IUD — some have a copper thread; others have copper cylinders. IUDs are placed in the womb and, depending on which version you chose, last between five and ten years.

The IUD has no hormones, which is why Alene chose it.

“I had been on the pill on and off since 2011 and every time I was on it I felt less incontrol of my emotions,” Alene explains. “The mood swings were so intense that I was having problems with productivity and my relationships with people. My mother and I would fight all the time and it was really getting problematic so I switched and it’s been so much better ever since!” Before choosing it, Alene did some of her own research.

“I think the really important thing is for young women to have the information. I did a Google search and read up on things before booking an appointment with my gynaecologist. She was really the one that helped me make up my mind about the IUD. We talked about all my options and we decided that the coil would be the best one for me.”

Like any contraception there are pros and cons. In this case, getting the IUD inserted can be painful.

“It's not something that you'd be looking forward to,” Alene laughs. “I'mnot sure how common this is, but the whole day afterwards I got cramps and they were pretty intense. But that was short-lived and by the next day I didn’t feel a thing. I would recommend anyone getting the coil inserted to take the whole day off, so that you don't feel under pressure.”

Alene believes the benefits outweigh a day of discomfort – by a million miles.

“It is absolutely worth it," she says with a smile. "It’s totally hassle-free – and I don’t have to worry about it until I want children. Mine lasts ten years, but if I want it taken out, that can be done easily – and I’ll be fertile again.”

Hormonal IUS

Bridget is in her mid-twenties and using a hormonal IUS. Like the copper coil, this is inserted into the womb, but it continuously releases a low dose of progestogen. The hormonal IUS lasts three to five years and is about 99.7 percent effective.

Bridget decided to switch for a very simple reason: this method of contraception bypasses human error.

“I was on the pill, which I had used since 2008," she explains, "but I kept forgetting to take it, so it was pointless. My doctor told me the hormonal IUS was a really effective form of contraception and that it could stop my periods, which sounded amazing to me!” Unlike Alene, Bridget had experienced no problems with hormonal contraception.

“I never experienced an side effects on the pill," she says. "But I'm just not good at remembering to take it. I didn't like that it was ineffective for a week if I forgot, so I thought I'd look for something that didn't have that element of human fallibility! I saw the IUS as something I could get and then forget about. Plus it was cheaper when you take all the doctor's visits and prescriptions into account.”

Insertion was relatively painless, says Bridget.

“My doctor gave me something to soften my cervix (neck of the womb) the night before and I was given painkillers to take an hour beforehand. It felt pretty much like a smear test, as there’s a speculum and there’s a PMS-type cramp when it's actually inserted. But I was surprised by how easy it really was.”

Bridget experienced mild cramps for a week afterwards. If there is a downside for her it's that, unlike the pill, the hormonal IUS doesn’t prevent acne.

“That’s been difficult," she laughs, "but the benefits have been great. The biggest bonus is that I now have no periods. That has been genuinely life-changing. I also love knowing I can't get pregnant for five years without really having to do anything.”

Bridget has some personal advice for women who are thinking of changing to the hormonal IUS.

“For reasons that I don't quite understand, lots of doctors seem to tell women that it's only suitable if you have had children, but in my experience that’s simply not true. I've also heard of women having it inserted without the cervical softener or painkillers. I'm not sure why you'd miss out on those simple precautions. I believe those two things are why it was so easy for me.

"So, if there is a final bit of advice, especially for young women, it is this: make sure you go to a sex positive doctor, who will make it as easy for you as possible!”

The Implant

Tanith is in her early thirties and has been using the implant for nearly six years. She swears by it.

The implant is a small plastic rod that is inserted into your arm. Progestogen is released in tiny doses, supplying the contraceptive into the system. The implant works for three years, at which stage it can be renewed – or not, if a woman decided that she wants to have children. It is one of the most effective forms of hormonal contraception. Less than one in a thousand women using the implant will become pregnant.

In a story that may chime with the experience of many women reading this, it was actually after a bad experience with her doctor that Yanith decided to switch to the implant.

“To be honest, I didn't like the doctor," she recalls. "Why he was working for a women's health clinic, I'll never know. He came across as old-fashioned and sexist. He referred to me as ‘a girl’ and was really condescending. I made my mind up to take my business and my body elsewhere, which is how I came to research other options and I heard about the implant.”

As well as being incredibly effective, in Tanith's experience, the insertion and removal of the implant was pretty straightforward. “For me, insertion and removal was fine. I'm not squeamish, but I'll admit I turned the other way as it was being done. It's inserted the first time with a needle. They make a cut in your arm for the removal, but it heals quickly enough. They insert the replacement at the same time as they remove the old one, and I was in and out of the clinic relatively quickly. I felt a tenderness in the arm for a few days, but it didn't feel that different to the tenderness you get after giving blood.”

The only downside, says Tanith, is the fact that there is an upfront expense.

“The outlay can seem hefty enough at the time," she states. "But of course it's not when you divide the cost by three years. In fact it costs a lot less. I did see a little weight gain, but nothing that can't be fixed with a bit of change to diet or exercise.”

More inportantly, for her the bonuses are numerous.

“There have only been positives," she says. "For one thing, my periods have stopped completely. Some people find that ‘unnatural’ – but honestly, I love it. No hassle, no cramps, no PMS, no interruption of my sex life – and you save a fortune on painkillers and tampons. I never noticed any change to my moods, but if there was one, it was probably for the better — no PMS!” She laughs. Clearly, for her, it is a no brainer. One suspects it will be for a lot more young women over the coming months and years...

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