Use of Long-Acting Reversible Contraception (LARC) and the Depo-Provera Shot in Adolescents

The intrauterine devices (IUDs) and the subdermal implant, collectively known as long-acting reversible contraceptives (LARC), along with the Depo-Provera shot, represent highly efficacious methods of birth control for all reproductive-age women, including adolescents. They are also safe, private, and convenient, and can be used for their noncontraceptive benefits. Additionally, LARC and Depo-Provera represent methods of contraception that do not contain estrogen and may be safely used in young women who have contraindications to estrogen-containing medications. The LARC methods have traditionally been underused by adolescents due to lack of knowledge and misperceptions about safety and effects on future fertility. How-ever, studies have found that when barriers to the use of LARC are removed, adolescents have increasingly chosen the IUD and implant for birth control and most continue to use these methods with satisfaction. This chapter will provide an over-view of IUDs, the subdermal implant and Depo-Provera, address barriers to care for adolescents, efficacy, continuation rates, common side effects and reasons for discontinuation, contraindications, and noncontraceptive benefits.