Long Acting Reversible Contraception
Long-acting reversible contraceptive (LARC) devices are birth control methods that provide effective contraception for an extended period of time. You do not have to think about contraception on a daily basis or every time you have sex, as with the oral contraceptive pill or condoms. Long-acting reversible contraception is highly effective in preventing unintended pregnancies, and can be stopped if you decide you want to get pregnant.
Long-acting reversible contraceptives include the following:
- Implants – these are inserted under the skin and last for up to 3 years.
- Intrauterine devices – these are inserted into the womb and last for 5 to 10 years before they need replacing.
- Contraceptive injections – these work up to 12 weeks before been repeated.
Currently all LARC methods are for women, as there are no long-acting reversible contraceptives designed for men yet.
| Copper IUDs | IUS | Progestogen-only injections | Implants (Nexplanon) | |
| What is it? | A small plastic and copper device which is inserted into the womb | A small plastic device which is inserted into the womb and slowly releases progestogen | An injection that slowly releases progestogen | A small, flexible rod inserted under the skin that slowly releases progestogen |
| How does it work? | Prevents fertilization and inhibits implantation of egg in the womb | Mainly prevents implantation of egg and sometimes prevents fertilization | Prevents ovulation | Prevents ovulation |
| How long does it last? | 5-10 years depending on type | 5 years | Repeat injections every 8-12 weeks depending on type | 3 years |
| Chances of getting pregnant? | Less than 2% of women over a 5 year period | Less than 1% of women over a 5 year period | Less than 0.4% over a 2 year period | Less than 0.1% of women over 3 year period |
| Could it affect chances of getting pregnant in the future? | No | No | It may take up to a year for fertility to return to norma | No |
| Affect on periods? | Periods may become heavier or more painful | For the first 6 months there may be irregular bleeding or spotting. Periods often become less frequent or stop after a year | Periods often stop, but some women experience irregular or persistent bleeding | Period pains may improve. Periods may stop, or become longer or irregular until removal of implant |
| Unwanted effect? | Risk of ectopic pregnancy is higher if a woman falls pregnant while using an IUD. | Risk of ectopic pregnancy is higher if a woman falls pregnant while using an IUS. May develop acne | May gain weight (2-3kg over a year) May cause thinning of the bones which is reversible on stopping | May develop acne |
| Checks needed whilst using LARC | Need check-up after first period after insertion. Regularly feel for threads of IUD to ensure it is still in place. See your doctor nurse if you experience any problems or want to have it removed. | The same checks apply as for the IUD. See doctor or nurse if you experience any problems or want to have it removed. | None – need to regularly receive repeat injections. See your doctor or nurse if you experience any problems related to the injection. | None. See your doctor or nurse if you experience any problems related to the implant, want to stop using it or have it removed. |
Make sure you have sufficient information from your doctor or nurse before you decide which long-acting reversible contraceptive is right for you. Information should be verbal as well as written. You’ll need to check with your doctor or nurse as particular contraceptive methods may not be suitable for you. Your doctor will enquire about your general health, medical problems, periods and previously used contraceptives. Before starting any method your doctor will need to check that you are not pregnant.
Some long-acting reversible contraceptives take effect immediately, depending on when in you cycle you start using them. Other methods may not be immediate in which case additional contraception may be required.
Long-acting reversible contraceptives do not protect against sexually transmitted infections (STIs). Condoms can help protect against these infections and your doctor or nurse can provide more information on this.
All the methods mentioned in this leaflet can generally be used by:
- Women of any age
- Women who have never had children
- Women who are breastfeeding, or recently have had a child
- Women who recently had an abortion
- Women who are overweight
- Women with diabetes
- Women with epilepsy
- Women who suffer from migraines
- Women who can’t use oestrogen containing contraceptives
- Women who are HIV-positive
