Roe v. Wade and Birth Control: What to Know About Access and Options

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Women’s health experts consider intrauterine devices, or IUDs, to be among the most effective forms of birth control, in part because people using them don’t need to remember to take or apply them, like a pill or a patch. A doctor inserts one of the T-shaped devices into the uterus, a procedure that typically lasts five minutes. Depending on the type, the IUD can remain effective for three to 12 years. .

There are two types of IUDs currently available:

Hormonal, which secretes progestin. “Very little” of the hormone is absorbed into the bloodstream, compared with oral contraceptive pills, Dr. Rosen said, so patients tend to experience fewer mood-related side effects. People who receive hormonal IUDs can have abnormal bleeding or spotting during the first three to six months after insertion. Then the bleeding typically becomes lighter and more regular, or goes away completely.

Copper, which doesn’t contain hormones. However, people with heavy or painful periods may want to avoid copper IUDs, Dr. Rosen said, because they can cause longer periods and heavier flows for some.

Nexplanon is a type of implant that is inserted under the skin of the upper arm and lasts for around three years. It also has the lowest failure rate of all birth control methods, according to Dr. Nippita.

A doctor or nurse inserts the small rod, which is about the length of a matchstick, and the process takes only a few minutes. No pelvic exam is required.

Side effects can vary from person to person. About a third of patients will experience “daily, abnormal, bothersome” spotting, said Dr. Rosen; another third will not experience bleeding at all; and the other third will simply have lighter, infrequent spotting. Some people with the implant also report mood swings, headaches, weight gain and acne.

Depo-Provera is an injection that contains progestin and protects against pregnancy for three months. A health care provider typically administers it, in an arm or the buttocks, every 12 to 14 weeks.

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