Q:        Good afternoon! I am a 23 year old female in graduate school who has recently entered into a monogamous, sexually active relationship, both of us negative for STDs/STIs. In the past, I never had sex enough to feel I needed to utilize birth control other than condoms, so I am just now researching my options for a long-term birth control. I do not plan on having a family, and am currently looking for a long-term, highly effective form of birth control.

My current dilemma is between a hormonal vs. non-hormonal implant/IUD, and I am deciding between Nexplanon, Mirena, or the Copper IUD ParaGuard. I have done hours worth of research, but still am having trouble deciding, as reviews from users and experts alike seem to vary from “very little to no side effects” to fairly serious or life-altering side-effects for the three above. (It basically seems like a game of “pick your side-effects” in exchange for peace of mind about pregnancy.) I am weighing the potential for increased flow and cramps (ParaGuard) with the possible effects of hormonal contraception (according to some of my reading: increased acne, weight gain, mood swings, lower sex drive). I already have some slight mood swings, and I find the possibility of increased mood swings, or loss of control of my own emotions a very scary prospect, but I know that this is not a guarantee. The potential for hormonal side-effects are really the only thing keeping me from getting one.

My question for you is: How would you counsel someone looking to make this decision? I have had trouble finding statistics on these side effects to really know what my risks are of incurring them. I have an appointment on April 17th, so I’m just gathering information until then.

Thank you so much for your time and expertise!

A:        Well, I apologize for missing your April 17th deadline.

I think a straight forward reply would be that each of the 3 long-acting reversible methods has advantages and disadvantages.  All are very safe and all are quickly reversible (but that seems not to be an important factor for you.Let's Get Serious Page 3 

What did you choose to use and tell me what your questions are now?  I promise to reply quickly.

 Good luck and I look forward to hearing what you decided on.

What are you studying?

I am looking forward to learning what your thinking is now.  You stated that it basically seemed like to “pick your side-effects”.

I would suggest that you also think of the phrase “pick your non-contraceptive non-side-effects benefits”. 

Please send me your address (we will not post it on our website).  I would like to send you some excellent information.

What contraceptive are you using this week?

Robert A. Hatcher MD, MPH

Emeritus Professor of Gynecology and Obstetrics

Emory University School of Medicine

Atlanta, GA

April 5, 2015, April 18, 2015, April 21, 2015


To learn more about the advantages and disadvantages of the Mirena IUD, the ParaGard IUD, Nexplanon implant and Depo-Provera injections, go to: www.managingcontraception.com.   You can order all of these books listed below from our website or by calling 404-875-5001. 

Key Words:       monogamous, sexually active, negative, STDs, STIs, birth control, condoms, long-term methods, options, effective, side-effects, hormonal, non-hormonal contraceptives, life-altering, pregnancy, flow, cramps, mood swings, low sex drive

Current Books:

Contraceptive Technology 20th edition

Managing Contraception 2015-2016 edition

Choices 2014 edition

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