LARCs are discussed in patients willing to undergo placement/removal and accepting of the possible complications (DVT, infection, etc). LARCs should be offered just to expand on patient options, but emphasized in patients who absolutely cannot tolerate OCPs.

I am a family practice physician who loves to recommend LARC to patients. I do not put them in or remove them, but have associates that will for me. An alternative to LARC that doesn't require insertion/removal would be an excellent alternative, which I was not aware of until now. I look forward to learning about ANNOVERA and coverage for it. If patients have one less thing to worry about in their contraception even better!

Replying to Dr. Susan Sumner, we were taught about LARCS plus how to insert/remove IUD and implant during residency. We had dedicated procedure office hours.

no one teaching family doctors to do iuds or implants no info given to us

Thanks for your contributions! What is your experience with early elective IUD removal? How can prevent this consequence?

I discuss the risks, benefits and side effects of the various options and do decide along with the patient on what’s best for them.
I do see a trend towards the IUD in the older age group while the younger college students mainly opt for the implant.
I’m aware of the vaginal ring option but it’s still new to majority of my LARC seeking patients who mostly already have an idea of what they want.

As a gynecologist obstetrician in active practice, I make it a point to discuss all forms of contraception with risks, benefits, alternatives as well as the challenges that each type of contraception provides, finding out the exact needs for the patient and then try to tailor the recommendation to the patient e.g. some patients may not be candidates for hormonal containing contraceptives. Most women although understand that the LARC methods i.e. IUCD are excellent in the protection they provide but are afraid of pain and discomfort during placement or have heard 'stories' from friends or other persons on social media. I use models to explain the exact procedure and try to minimize pain during placement, most patient at the end of the placement state "It was a lot better and comfortable than what I thought it would be". I do offer and discuss Annovera, the long acting patient controlled vaginal ring for contraception with its advantages and disadvantages, and many patients have tried it and are very happy with it, after the initial questions about its 'reusability' for 13 cycles! Steadily over the years the IUDs have become more and more popular and most women come to me stating their desire to place an IUD, including nulligravid women. When a woman desires a LARC but does not yet accept the commitment, I offer the Annovera, so that the woman has a non-uterine LARC which she knows she can control -- most women are happy with this arrangement and many of them have gone on to take the uterine placed LARC Paragard/Mirena/Liletta/Skyla.

I have been doing family planning for over 30 years. The population is mostly between 15-30 years of age. I try to encourage LARC. I start the discussion with least length to the most lengthy time of the device. The objective goal is to decrease the chances of birth control failure.. We have an open discussion about how unwanted pregnancy can affect their lives. We then talk about the minor side effects that are easily managed. The option of stopping the device and return to normal is discussed as well..

Every reproductive age woman/girl should have a thorough discussion regarding contraception and preventing unplanned pregnancies. Many are afraid to take anything, some are afraid the parents would find out, some cultural norms and myths come into play. An open and honest discussion will enable a young woman to consider contraception and make her proactive about her choices

Having the talk of contraception is very important with our patients. Every patient is different and advising patients on contraception that is geared towards them is even more important.

All women of reproductive age group should receive some form of discussion about contraception. The best method for the patient will be based on several factors such as age, risk factors, past experience with contraception/LARCs, length of anticipated use etc. It is best to address any concerns that they have. Most fear about undergoing a “procedure”, some consider themselves not good with “tolerating pain”, some prefer a one and done approach as they feel remembering to take OCPs daily is a chore. Some also base it from their relative’s and friend’s experience. Discuss advantages and disadvantages of each method and the need for a backup contraception if necessary. Depending on the situation, patients should be reminded that LARCs don’t protect them against STIs and remind patients that they still need to come for their annual physical/GYN visit despite having a LARC in place. It is important to individualize care for each patient. Would like to learn more about the LARC alternative.

Many patients can be interested in IUDs if discussed in detail and discuss all options in detail

Need discussion with patient about risk factors, ease of use, hx of smoking, DVT, migraines and asses suitable birth control

Many love the idea of LARCs, but do not want to undergo a "procedure." The conversation of all available options is presented and then they can choose from those. I have found that most are much more happy with their eventual decision when they feel that they have really discussed all options and decided on one. That being said, there are many that change their mind before any "procedure" driven option and usually choose oral BCPs instead.

Conversations around LARC's and other birth control options are centered around patient risk factors (ie VTE hx, migraines with aura, etc), if they already have an idea of the type of birth control they are interested in, and different options available. There is a discussion of if they have any potential plans (ie looking for something long term or not), potential side effects, and other symptoms they are experiencing in regards to their menstrual cycle that may be modulated by different types of birth control. Some patients with LARC are worried about undergoing a procedure and the possible pain associated with IUD insertion. Ultimately, clinicians should help patients to find a birth control that most safely suits the individual patient and their needs.

There is the concern about digital data collection with implants leading to social credit scoring and governmental increased control. Some women are worried about microchips and "the mark of the beast" of the Bible. Anything injectable or implantable does have the capacity to be used for surveillance without consent due to advanced technology.

LARCs are discussed in patients willing to undergo placement/removal and accepting of the possible complications. Some women absolutely cannot tolerate OCPs, in which case LARCs are offered to allow the patient to make the best decision. I am not aware of the alternative and very much have patients not willing to commit to LARCs though being ready.

The patients have asked about it but are concerned about having a procedure and end up with using an OCP.

LARC’s should be discussed along with other methods, then it will be totally up to the woman to decide; it is her life.

It’s necessary to discuss all of the pros and cons…the patient must be mentally prepared

I do discuss all LARCs with patients and take into account their fears of side effects in tailoring the discussions. I also spend a lot of time talking about adjustment and also the fact that almost any LARC (except DepoProvera) is fairly easily REVERSIBLE if they give it a try and are very concerned with persistent side effects. Just because something lasts 1, 3, 6, 7 or 10 years doesn't mean a patient MUST leave this method in place; that is reassuring to patients who are otherwise hesitant to commit to a LARC.