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Choosing the right kind of contraception is a hard task, as many effective and varied options are available. For example, birth control implants and IUDs are both legit options, but they may vary with individual situations and health choices.

Let’s discuss the different working mechanisms, effectiveness, advantages, side effects and risk factors to help one make the right choice.

Birth Control Implants

A birth control implant is a flexible plastic rod that is small enough to fit inside the skin of one's upper arm and causes no problem.

It releases a small amount of progestogen hormone continuously into the bloodstream. An implant prevents pregnancy by warding off the release of an egg during ovulation.

It also thickens the cervical mucus and thins up the lining around the uterus to prevent fertilisation. It can last for 3 years.

IUDs

There are two types of IUDs. One is hormonal, and the other is non-hormonal. The hormonal IUDs work just like the implant, but it is placed within the uterus.

The non-hormonal IUD or a copper-bearing IUD works by releasing copper ions, which affect sperm motility and prevent it from reaching the egg. It also changes the cervical mucus and makes implantation impossible.

Both of these birth control methods work from within our bodies. People need healthcare assistance to start using the devices. Let's look at how implants and IUDs are inserted.

Birth Control Implants

A medical professional will use local anaesthesia to numb the area inside one's upper arm. After the anaesthesia kicks the doctor will insert the implant into the arm, which will feel like an injection.

One has to replace the implant when it expires.

IUDs

Before IUD insertion, the concerned medical professional would check one's uterus and make sure that the woman has no underlying issues like pelvic inflammatory diseases (PID) or STIs.

During the procedure, a doctor will place a speculum to keep the vaginal wall open and insert a tube where the IUD is put. Then he or she will insert the tube through the cervix into the uterus and put the device there.

Before the fitting, the concerned physician can advise one to have a check-up after 3 to 6 weeks to ensure everything is working correctly.

To ensure the effectiveness of these hormonal methods, one can avoid certain factors that can decrease the effectiveness of the devices. Let's take a look at the factors one at a time:

Some Medications

Some medicines for antifungal treatment like griseofulvin, some antiretroviral therapies for HIV, medicines for epilepsy that are enzyme-inducing, an antibiotic named rifampin etc., can decrease the hormone levels of birth control implants and IUDs.

Hence, discussing with a doctor before deciding on a birth control method is crucial.

Mistakes on the Users’ Part

Mistakes like not waiting long enough after an implant or a hormonal IUD can drastically decrease the system's effectiveness. Or, missing the expiry date of a device can result in an unwanted pregnancy.

One can look out for such factors and stay on the safe side with these birth control methods. Now let's discuss what makes these methods so effective or why they are so popular.

Birth control implants and IUDs are among the most effective pregnancy prevention methods. Here is a list of their advantages:

Advantages of Birth Control Implants:

• Effectiveness: A birth control implant or Nexplanon can prevent pregnancy with more than a 99% success rate. It is as effective as an IUD or sterilisation method. These implants work so well because it does not involve the user in their activity. The user cannot use it incorrectly or forget to use it. They can forget about the implant and be free of worry.
• Better Periods: Implants can make someone's periods better by lessening the cramps and lowering the bleeding. Many people also have no periods after a year of implant usage. However, they can resume their periods if they remove the implant.
• Privacy and Convenience: This birth control method is not only one of the cleanest and safest of all the methods, it is also very private and convenient. Only the insertion and the removal involve people; otherwise, no one else can know about the implant by any means. It provides a user with a convenience that very few other methods of pregnancy prevention can.
• Mono-hormone System: Birth control implants consist of one hormone only, which is progestin. Many birth control methods involve progestin and oestrogen. For many people, oestrogen can create health problems and decrease the method's effectiveness.  Nexplanon is oestrogen free and does not involve any risks associated with it.
• Easy to Revert Back: This method of birth control implant is easily reversible. Whenever one feels that it is the ideal time to have a child, one can get it removed and regain back one’s fertility within a small period of time. A birth control implant has no impact on one's fertility. As soon as the implant is out, a woman is ready to be pregnant.

Advantages of IUDs:

• Effectiveness: IUDs are one of the most effective birth control devices out there. It has a higher than 99% success rate. It is also as effective as sterilisations or implants. This device is so successful due to its zero-user-involvement nature. A user cannot forget to use it, like pills, or use it incorrectly, like condoms. Once it is inserted, a user can forget about it for 5 to 12 years, depending on the type of the IUD.
• Better Periods: Just like the implant, hormonal IUDs can make one’s period more bearable by making the cramps lighter and lowering the bleeding.
• Privacy and Convenience: Same as the implant, no one can see that one has an IUD fitted on their uterus. An IUD insertion also needs two visits for insertion and removal, like an implant.
• No-hormone System: Unlike birth control implants, IUD has another option where the copper ions do the work. It involves zero hormones. Copper-bearing IUD is very effective in preventing pregnancy as it is the most recommended by WHO. People who do not want to engage in hormonal methods, or cannot use hormones due to health conditions, prefer copper-bearing IUDs.
• Copper-Bearing IUDs Can Act as Emergency Contraception: If one has unprotected sex and inserts a copper-bearing IUD within 5 days, they can prevent a pregnancy. As it not only prevents sperm from reaching an egg, it does not allow the implantation of a foetus.

Birth Control Implants – Side Effects and Risk Factors

• Amenorrhea (Absence of Periods): Amenorrhea means missing one or more periods or absence of menstruation. It can happen due to anatomical and hormonal reasons. Birth control implants can disturb the internal hormonal balance of the body and cause one to miss their periods.
• Ovarian Cyst: Ovarian cysts can develop due to disruptions in menstruation. One can identify an ovarian cyst if one feels bloating, heaviness in the underbelly, or a stinging sensation on one side below one's belly button.
• Headaches: Many people report having headaches after using birth control implants; however, it generally goes away within the first month of use. If one’s headache does not go away, an individual needs to visit a doctor immediately.
• Nausea: In many cases, when a woman starts to use a hormone-based birth control method, she feels nauseous. It can continue up to 3 months after the insertion; however, if nausea disrupts her flow of life, she should consult an expert to find a solution and relief.
• Vaginal Dryness: In very few cases, the use of implants is linked with vaginal dryness or inflammation. It may get resolved automatically; if it does not, one should inform a doctor.
• Mood Swings: The usage of hormone-based birth control methods can sometimes invigorate underlying mental health disorders. For example, people can see increased ups and downs in their moods after starting to use an implant.
• Breast Tenderness: Birth control implants can increase the heavy feeling or dull aching pain in one’s breasts. The hormonal activity of an implant can make the pain stronger.
• Decreased Sex Drive: Getting a decline in one's libido can be due to the use of a birth control implant. However, there are cases where people report having a higher sex drive after starting to use the device.

IUDs –Side Effects and Risk Factors

• Ectopic Pregnancy: Ectopic pregnancy is very rare among users of IUDs. An ectopic pregnancy is a situation where a sperm cell has reached an egg through the fallopian tube and fertilise an egg, and the implantation has occurred outside the uterus.
• Perforation: One of the most severe risk factors of IUDs is that they can perforate a uterus. This can happen in several ways such as a miscalculated insertion of a device or its breakage and migration. This can lead to pelvic inflammatory diseases (PID) when involving a professional becomes necessary.
• Pain: Insertion of an IUD involves some amount of pain. Depending on the individual, the pain can be manageable or severe. A tube is passed through the cervix to insert a device, which can cause cramps. Generally, pain and cramps go away with time. However, for copper IUDs, cramps can stay comparatively longer.
• Uterine Infection: Within 3 weeks of the IUD insertion, there can be a slim chance of getting uterine infections. The chances of getting infections are higher for women more prone to STIs. Additionally, if someone has pelvic inflammatory disease, it can be treated after fitting the device.
• Moved IUD: Movement of an IUD is very rare, but it can cause serious problems. It can cause vaginal bleeding, abnormal discharge, pain in the underbelly, severe cramps, fever due to infection etc.
• Expulsion: An IUD can get out of someone’s uterus and cause sharp pain. An expulsion can be complete or partial, and it generally happens during periods. To check if one's IUD is still in place, one has to check the thread attached at regular intervals.
• Risk of Sexually Transmitted Infections (STIs): During an insertion process, there is a slight risk of Sexually Transmitted Infections (STIs)

First, let's discuss the eligibility criteria and suitability of individuals for getting IUDs and implants. Most women are suitable for these methods of birth control; however, in the following scenarios, it is not advisable:

• Where an individual is taking medication that can decrease the effectiveness of a device
• When an individual has a history of heart and arterial diseases
• Someone with breast cancer, uterus cancer or a history of cancer
• A woman having inexplicable vaginal bleeding in between periods or after sex
• If someone does not want to change their periods
• When someone is pregnant

If someone is in the above-mentioned scenarios, they can consult a physician and discuss which method of birth control will suit them the best.

Otherwise, one should consider the above-mentioned factors, like both of the method's advantages, side effects and risk factors, to make the right decision. Even so, it would be wise to consult a physician before taking a decision, as both of the methods are long-term in nature.

Sterilisation

For a woman, the surgical sterilisation process is called ligation or tubectomy, where the fallopian tubes are cut or tied up permanently. It prevents the release of an egg from the ovaries.

For a man, the surgical sterilisation process is called vasectomy, where the sperm-carrying tube is cut and tied permanently. It prevents the sperm from reaching the uterus of a woman.

These are the most effective and permanent methods of birth control.

Behavioural Methods

The behavioural method includes contraceptive abstinence and withdrawal. However, the safety withdrawal can be controversial. Contraceptive is highly effective as it ensures that the male and female reproductive cells never come in contact with each other, thereby preventing fertilisation.

Natural Family Planning

This method of birth control involves an understanding of bodily signs and symptoms of fertility. With this understanding, one can plan when to have intercourse to avoid fertilisation.

To make this worthwhile, one has to learn how to read the physical signs from an experienced teacher. One can contact a nearby fertility awareness clinic to learn more.

Natural family planning generally revolves around these three major signs:

• Readings of one’s body temperature 
• Length of a menstrual cycle
• Changes in one’s cervical mucus

Barriers

The usage of various barriers, if done correctly, can be as effective as any. These methods use a barrier to prevent sperm from reaching the female genitalia. Examples of barriers include condoms, sponges, diaphragms, cervical caps etc.

This article provides a comprehensive idea about implants and IUDs, two of the most potent contraceptive methods. It gives a brief idea about how it works and discusses its advantages with side effects and risk factors.

Before opting for either of them, one should consult a doctor and choose what is right based on their individual situation and health condition.