Blog of the Society for Menstrual Cycle Research

Do you love your LARC?

December 12th, 2012 by Laura Wershler

Throughout the contraceptive realm, LARCs are being heralded as the best thing since Cinderella’s glass slipper with little acknowledgement that for many women LARCs are more like Snow White’s poisoned apple.

Nov. 25 to Dec. 1, 2012, was LARC Awareness Week, billed by the California Family Health Council as “a chance to increase awareness about LARCs as a safe, effective, and long-acting birth control method.” Women were invited to contribute video messages on the theme Why I Love My LARC.

This catchy acronym stands for long-acting reversible contraceptive, and the push is on for many more women to choose this form of birth control. Make no mistake, it’s all about control: What the doctor puts in, only the doctor can take out. Ergo, it’s 99% effective. You can quit taking your pills, rip off your patch, or NOT show up for your next Depo-Provera shot. But if you hate the side effects caused by your IUD or implant, you’ve gotta go see a health-care provider to have it removed.

I’ve challenged the Contraceptive Choice Project study that praised the effectiveness of LARCs over the pill, patch and ring. I took issue with the ACOG recommendation that LARCs are the best methods for teenagers. Now there’s more hype with LARC Awareness Week.

According to the awareness campaign, LARCs include the ParaGard (copper) IUD, Mirena (progestin) IUD and Implanon, a non-biodegradable flexible rod, also containing progestin, that is inserted under the skin and left for up to three years. (Here’s a story about the rods going missing in women’s bodies.) Read the patient information about Implanon. Would you agree to have it inserted into your body?

Women who hate Implanon are speaking out. So are women who don’t love their ParaGard or Mirena IUDs. On YouTube, a video by a women with Mirena issues has over 6000 views;  Why I Love My LARC, posted 8 days earlier, has about 100.

The old-school LARC – Depo-Provera – is not on the campaign’s list of LARCs, though it is heavily used in the United States. Holly Grigg-Spall recently reported that “one in five African American teens are on the Depo shot, far more than white teens.” Hmm. Will they all be switched to other LARCs when, or if, they come back for their next shot? Perhaps Depo is not on the list because women can discontinue this contraceptive without clinician intervention. But it’s probably because Depo causes bone density loss – and because this LARC is not a lark. Women are sharing their Depo stories on another re:Cycling post:  Coming off Depo-Provera can be a women’s worst nightmare. You can find more bad news about this LARC than any other.

What about getting your LARC removed if you hate it instead of love it? One re:Cycling blogger shared what happened when she wanted her ParaGard IUD removed:

I HATED the thing but the nurse who was supposed to take it out tried to talk me out of it for a good 20 minutes. Finally I was like ‘”Why do you want me to keep this item in my uterus so badly?” And she said, “I just don’t want to see you get rid of your very effective birth control.”

This is not the only reason why women who end up hating their LARCs will be discouraged from rejecting them. The Affordable Care Act requires all health plans issued on or after August 1, 2012 to provide no-charge access to FDA-approved LARCs. What’s it going to take to convince health-care providers to remove an expensive contraceptive – provided for free – that was supposed to last for three to 10 years?

Maybe a YouTube video about Why I Hate My LARC will help make it as easy to get rid of one as it now is to get one.

  

6 Responses to “Do you love your LARC?”

  1. [...] available to all women and then letting them choose for themselves? In her latest re:Cycling post, Werschler complains about the hype of LARC Awareness Week, billed by the California Family Health [...]

  2. I think the excitement about the Mirena and the implant also has something to do with this obsession with technological fixes. Technology will save us is the motto of today. In a sense these devices are gadgets of a sort – we all love gadgets these days – and although not strictly “new” they are promoted as modern, up-to-date. I think there’s an effort to make the pill seem old-fashioned. Even though its effectiveness has been boosted for decades, we’re now seeing the pill’s effectiveness undermined (albeit because of women’s failings and not the drugs).

    • Laura Wershler says:

      I think you’ve nailed some key themes, Holly: technology, gadgets, the pill as old-fashioned and not even that reliable anymore! It reminds me of what happened to the diaphragm’s reputation when the pill came along. What was once the queen of contraception was then denigrated as unreliable compared to the pill. Now it’s happening to the pill. LARCs are new!High tech! Superior!

  3. What concerns me too is how the copper IUD is lumped in with the Mirena, and as such the hormonal impact of the Mirena and the side effects specific to that are dismissed, swept under the carpet. And I think if you go to the doctor or Planned Parenthood looking for an IUD without much knowledge you will be first offered the Mirena, because of Pharma backing, marketing and because of what it does to your periods in comparison. I don’t think you’d be offered the copper IUD unless you specifically demanded it.

  4. [...] quote my blog post about the earlier campaign: “Throughout the contraceptive realm, LARCs are being heralded as [...]

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Readers should note that statements published in re: Cycling are those of individual authors and do not necessarily reflect the positions of the Society as a whole.