Long-acting or permanent birth control options give people one less thing to think about on a daily basis

People who aren’t planning on a pregnancy anytime soon might prefer long-acting birth control or permanent options rather than stocking up on condoms or remembering to take a pill each day. Long-acting birth control options can last several months or years. 

Contraception is often called birth control, but it isn’t just used to prevent pregnancy. Some varieties also help ease painful periods, so people who menstruate can spend less time laid up with a heating pad.

The benefits of long-acting birth control include not having to think about it every day. But some birth control options include hormones that can come with side effects, like weight gain, nausea, and period changes. Long-acting birth control options do not prevent sexually transmitted infections.

There are also several permanent options for both men and women, for those who are certain they do not want to become pregnant or father a child. 

Discuss your goals with your healthcare provider, who can help you pick the best birth control option for your needs. Your healthcare provider will probably ask if you want to have children in the future and how heavy or painful your periods are.

“There's something right for everybody, so it's so nice that we have long acting and permanent options for contraception,” said Laura France, MD, an obstetrician and gynecologist at M Health Fairview Clinics – Maplewood.

France gave an overview of long-acting and permanent birth control options.

Implant

Nexplanon is a small, thin rod that is implanted in the arm. It releases the hormone progesterone to prevent pregnancy for up to three years. It can be implanted or taken out in an office visit. Once the device is removed, fertility comes back quickly, France said.

The downside of implanted birth control is that it can cause unpredictable bleeding.

“The reason most people have it removed is irregular bleeding,” France said. “It’s usually lighter and more sporadic than a period.”

Injection

The hormone progesterone is given as a shot, often referred to by the brand name Depo-Provera. It’s given every three months to prevent pregnancy. Most people experience much lighter periods by their second dose, France said.

It can take up to 18 months for fertility to come back, though some people will be able to get pregnant after just a month or two. Weight gain is common with progesterone. It can also worsen mental health issues. France notes that birth control pills can also affect a person’s mental health.

“With the pill, though, you can just stop taking it,” France said. “Once you get the shot, it’s there until it’s worn off.”

Intrauterine Device (IUD)

IUDs are devices inserted into the uterus to prevent pregnancy. Once inserted, you don’t have to think about birth control again for up to 10 years. The devices can be inserted in an office visit and quickly removed the same way. There is some discomfort involved with the placement and removal, so France recommends people take ibuprofen before the procedure.

“It is uncomfortable for everybody,” France said. “Anything that makes our cervix open makes us cramp. That's true whether that's putting an IUD in, doing an endometrial biopsy, or passing big clots because our periods are really heavy.”

IUDs are fast-acting.

“With all of the IUDs, they become effective pretty much immediately and their effectiveness goes away as soon as you take them out,” France said. 

There are two versions of IUD: Hormone-containing and non-hormone-containing. Because the hormones contained in IUDs don’t go through the whole body, they are less likely to cause side effects like nausea, weight gain, or changes in mood that other forms of hormonal birth control can cause. The hormone containing IUDs do usually make periods lighter over time. Periods can be heavier with the non-hormonal option, France said.

Removing fallopian tubes

You may have heard the term “tying the tubes,” known medically as tubal ligation. This blocks the fallopian tubes so the egg can’t meet the sperm. But now medical researchers know that a significant portion of ovarian cancers start in the fallopian tubes. Now, it’s common to have the fallopian tubes removed instead, if a person knows they don’t want more – or any – children. Called salpingectomy, the procedure also helps prevent ectopic pregnancies, which was a risk with tying the tubes. An ectopic pregnancy occurs when a fertilized egg can’t get to the uterus and begins growing elsewhere.

Tube removal is a laparoscopic procedure that requires two or three small surgical incisions. Recovery time is just a few days.

It’s common for people in their 30s or 40s who are not planning future pregnancies to look for a permanent birth control option along with help controlling a monthly flow that tends to get heavier around that time, France said.

“When somebody comes in to talk to me about something permanent, I always ask what their periods are like,” France said. "Options like having the tubes removed will not help their periods at all. So some people still end up on hormonal birth control to help with the periods.”

Male vasectomy

For heterosexual couples who aren’t planning future pregnancies, male vasectomy is a low-risk and permanent birth control option. Learn more about vasectomy.

Talk to your healthcare provider

You can discuss contraceptive options with your primary care or women’s health provider.

Both tube removal and IUD insertion can also be done at the time of childbirth to eliminate the need for another office visit. Minnesota state insurance programs are required to pay for long-acting contraception immediately after childbirth.