What I Wish All Teens Knew About Long-Acting Birth Control

There are many excellent birth control options for teens. As an ob-gyn, I often recommend that teens consider long-acting reversible contraception, or LARC.

LARC methods include IUDs (intrauterine devices) and the birth control implant. The implant is a small rod that is placed just under the skin of your upper arm. The IUD is a small, T-shaped device that is inserted into and left inside the uterus.

IUDs and implants prevent pregnancy better than any other type of birth control. Over time, these methods are 20 times more effective at preventing pregnancy than birth control pills, the patch, or the ring. And if you want to get pregnant in the future, fertility returns within a week of removing an implant or IUD.

LARC methods may also help with period concerns. About 20 to 50 percent of those who use certain IUDs will stop having their period within a year.

I used to tell my teen patients and their parents that I would recommend LARC methods to my own daughters. Now I can say that I actually have. When one of my daughters was 13, she asked me about using an IUD to stop or lighten her periods.

She wasn’t having sex, but she’s an athlete and wanted to skip her periods if she could. I talked it over with my daughter, and she decided to have one placed. She likes the IUD and is happy to no longer deal with her period.

Here’s what I’d like all teens to know about LARC.

Birth control implants and IUDs are safe. And they're far safer than pregnancy, especially for teens.

Some teens and their parents worry about the possible side effects of LARC, particularly IUDs. Some have read misinformation on social media claiming IUDs are harmful. Some think only women who are older or who have had a baby can use the devices.

None of these things are true. IUDs are safe and effective for teens. Serious side effects with current IUDs happen in less than 1 in 100 people who use them. Problems are also uncommon with the implant.

Pregnancy is much riskier than any form of birth control, including LARC. And that’s just in terms of the medical issues that can develop during pregnancy. When a teen has an unplanned pregnancy, it can disrupt her life, education, or ability to find or keep a job.

IUDs and implants let teens only think about birth control every few years.

With a LARC method, teens need to take only one action to prevent pregnancy. That’s to visit their ob-gyn and get the implant or IUD placed. They can get it and then forget about it.

That’s why LARC options are so effective. It’s also why patients report higher satisfaction and continuation rates with IUDs and the implant than with any other form of birth control.

The implant is approved for up to 3 years of use. It works by releasing the hormone progestin into the body.

How long you can use IUDs depends on the type:

• Hormonal IUDs release progestin into the uterus. There are several different brands. They are approved for up to 3 to 8 years of use.

• Copper IUDs don’t use hormones. They release copper into the uterus, which makes it hard for sperm to move and reach an egg. They are approved for up to 10 years of use.

Ob-gyns can help teens choose birth control that best fits their needs and concerns.

Teens have different goals and fears when it comes to birth control. Some want lighter or no periods. Some are afraid of the discomfort that can happen with a pelvic exam or IUD placement. Some teens worry they may need a parent’s permission for LARC. (Most states don’t require this, but you can check your state’s laws or ask your ob-gyn.) Some teens may decide LARC isn’t for them, and that’s okay. We’ll discuss all the other options too.

If teens are choosing between LARC methods, here’s what I share:

• You don’t need a pelvic exam to get the implant.

• The implant can cause irregular bleeding, but about 1 in 5 users stop having their periods eventually.

• You do need a pelvic exam to get an IUD. Placing the device can cause a few minutes of cramping. For some teens this is minor, but others can have severe cramping.

• The copper IUD prevents pregnancy the longest, but it can make your period a little heavier or crampier.

• Some hormonal IUD brands are more likely than others to lighten or stop your period. If that’s a goal, we can choose one of those.

[Why the Birth Control Implant Works Well for Me]

IUDs and the implant don’t prevent STIs (sexually transmitted infections).

That’s why teens who use LARC also need to use a condom every time they have sex. Those age 15 to 24 have the highest rates of STIs of any age group.

Teens who are having sex should get tested for STIs once a year or whenever they have a new sexual partner, whichever comes first. We can use urine or blood tests to check for these infections. There’s no need for a pelvic exam unless the teen has concerns.

Teens can speak with me privately.

I try to give all my teen patients the opportunity to speak with me alone. Often, these private talks are when teens reveal they’re interested in birth control. Sometimes parents are aware of these conversations and sometimes they’re not. But I try to make sure all my teen patients know our relationship is a safe space for them.

In some cases, state laws or insurance policies may limit what health care services for minors can be confidential. I encourage teens to always ask their ob-gyn what can be kept private, and whether there’s anything that needs to be shared with parents or that might show up on an insurance bill.

Ob-gyns are here to help.

We want teens to feel comfortable talking with their ob-gyn about birth control and sexual activity. Our goal is to empower them with information that can help them make the best decisions.

Copyright 2023 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.

This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.