Early intrauterine devices have been around since 1929, but “IUDs are underappreciated and underutilized in the US,” says OB/GYN Mary Rosser, MD, PhD, of Montefiore Medical Group’s Larchmont Women’s Group. “A lot of people remember [older versions] from their mothers and grandmothers, and are afraid to use them. Their resurgence has been led not just by drug companies, but family-planning gurus have come to the forefront and said they are very valuable.”
Dr. Rosser herself advocates the no-maintenance aspect of LARC—long-acting reversible contraception—a category that includes both IUDs and implants. While an IUD like Mirena or Skyla is 99.8 percent effective for up to five years at a time, implants (matchstick-sized rods inserted into the arm) such as Nexplanon are 99.8 percent effective for three, making them the most effective nonpermanent methods of birth control available. In European countries like Norway and Sweden, average usage rates are around 27 percent; in the US, it’s just 2 percent.
Both methods involve “very few complications and are very safe,” says Dr. Rosser. “Studies say they’re good for almost all women.” Plus, she adds, they’re discreet and confidential, are shown to improve heavy menstrual bleeding and cramping, and have a very low risk of infection. While unpredictable spotting is one minor possible side effect, there’s no effect on later fertility, and a device may be removed at any time.