For many, changes in the political landscape and uncertainty of health care access have sparked interest in reliable contraceptives that don’t require daily upkeep or frequent renewal. If you’re considering a long-term birth control solution, this guide will walk you through your options, the benefits of each, and how to access them.
Hey Jane offers over 100 birth control options including different types of the pill, patch, shot, and non-hormonal options. We also offer two types of the ring, including Annovera which can be used for up to 1 year. Want to learn more? Schedule an online consultation with one of our expert and compassionate providers. Get started here.
Why choose long-lasting birth control?
Birth control options like IUDs and arm implants provide peace of mind, offering years of effective contraception without the daily reminder of a pill. They are discreet and generally low-maintenance, making them a popular choice for people with varying lifestyles and needs.
They also have high efficacy rates and low failure rates, providing reassurance that they work well in preventing unintended pregnancies. Additionally, many long-term options are reversible, meaning you can stop using them when you don’t need them anymore.
Types of long term and permanent birth control
| Method |
Efficacy |
How it works |
How long it lasts |
| Hormonal IUD |
Over 99% effective |
This small t-shaped device releases progestin which thickens cervical mucus, making it harder for sperm to reach an egg. It can also stop ovulation and prevent eggs from leaving the ovaries. A bonus of hormonal IUDs is that they can lead to lighter periods.
Brands include Mirena, Skyla, Liletta, and Kyleena.
|
3 to 8 years depending on the type |
| Non-hormonal (copper) IUD |
Over 99% effective |
This small t-shaped device releases copper to create an environment that prevents sperm from fertilizing an egg.
The only copper IUD available is ParaGard.
|
10-12 years |
| Hormonal arm implant |
Over 99% effective |
This thin plastic rod is inserted under the skin of your upper arm. It works similarly to hormonal IUDs by releasing a steady stream of progestin to prevent pregnancy.
The only arm implant available is Nexplanon.
|
3 years |
| Hormonal vaginal ring |
Over 97% effective |
You can insert this ring on your own at home right after your period, keep it in for 3 weeks, then remove to start your next period before re-inserting. It can be reused for up to 13 cycles.
The only hormonal vaginal ring that lasts for 1 year is Annovera.
|
1 year |
| Tubal ligation (procedure) |
Over 99% effective |
Also known as “having your tubes tied,” this procedure blocks or seals the fallopian tubes, preventing eggs from reaching the uterus.
|
Typically permanent |
| Vasectomy (procedure for semen-producing partners) |
Over 99% effective |
A minor procedure that cuts or seals the vas deferens, preventing sperm from being released during ejaculation.
|
Typically permanent, though sometimes reversible |
Hormonal vs. copper IUDs
Hormonal and copper IUDs function a bit differently, but are both incredibly effective at preventing pregnancy for many years without daily maintenance. Here’s how they compare:
| Attribute |
Hormonal IUD |
Copper IUD |
| Efficacy |
Over 99% effective at preventing pregnancy |
Over 99% effective at preventing pregnancy |
| Lifespan |
3-8 years depending on the brand |
10-12 years |
| Side effects |
Irregular periods
Some patients prone to acne or facial hair report worsening symptoms
|
Increased menstrual bleeding and cramping
|
| Impact on period |
Can reduce heavy and painful periods, or eliminate them entirely in some cases; also used to treat heavy menstrual bleeding.
|
Can make periods heavier and more painful in some cases—usually in the first 6 months. After that, most people’s periods return to normal.
|
| Benefits |
Progestin-only, meaning it’s suitable for people who cannot take estrogen.
|
Non-hormonal, and is also the most effective form of emergency contraception if inserted within 5 days of unprotected sex!
|
IUDs vs. Nexplanon
Hormonal IUDs and the hormonal arm implant (Nexplanon) are different devices that function in pretty similar ways. Here’s how they compare:
| Attribute |
Hormonal IUD |
Nexplanon |
| How it’s inserted |
You can talk to your provider about pain and anxiety medication before your appointment. The provider will insert a speculum into the vagina to view the cervix (similar to a pap smear). Then, they’ll cleanse the cervix to prevent bacteria from entering the uterus. A “sound” (a thin tool) is used to measure the uterus, followed by inserting a small tube with the IUD through the cervix and into the uterus, where it’s released. The procedure takes about 10 minutes.
|
Your provider will start by numbing the area with an injection to reduce pain, or you can discuss pain and anxiety medication to take beforehand. Then, they’ll use an applicator to insert the small rod under the skin on the inside of your upper arm. The procedure takes about 10 minutes.
|
| Efficacy |
Over 99% effective at preventing pregnancy |
Over 99% effective at preventing pregnancy |
| Lifespan |
3-8 years depending on the brand |
3 years (FDA studies show good efficacy for up to 5 years) |
| Side effects |
Irregular periods |
Irregular periods |
| Impact on period |
Can reduce heavy and painful periods, or eliminate them entirely in some cases
|
Can reduce heavy and painful periods, or eliminate them entirely in some cases
|
| Benefits |
Progestin-only, so suitable for people who cannot take estrogen.
Cannot be felt by a partner (especially if you ask your provider to cut the removal strings short, or leave them long so they wrap up and stay out of the way).
|
Progestin-only, so suitable for people who cannot take estrogen.
|
Are long-term and permanent birth control options safe?
Yes, for most individuals, these methods are very safe. Each option has potential side effects that vary depending on the type. Long-lasting methods like IUDs, Nexplanon, and Annovera do not impact future fertility once removed, but procedures like tubal ligation and vasectomies are intended to be permanent. It’s best to discuss your medical history and health concerns with a healthcare provider to find the right option for you.
Where can I get an IUD or Nexplanon?
While the insertion of IUDs and Nexplanon implants require an in-person visit, telehealth providers like Hey Jane can guide you through your options if looking for the pill, patch, ring (including Annovera which lasts for 1 year), the shot, and non-hormonal methods.
Can I get a one year supply of the pill?
Yes! In most cases, you can ask your provider for a prescription that provides a 3, 6, or 12 month supply of the pill. 22 states plus Washington D.C. require insurance companies to cover an extended 12 month supply of birth control at once. If your insurance doesn’t cover the 12 month supply, or if you aren’t using insurance, you can pay out-of-pocket. Sites like GoodRx can provide discounts to help lower these costs.
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