Long-acting Reversible Contraception (LARC)
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.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
| Copper IUDs | IUS | Progestogen-only | Implants (Nexplanon) |
| injections |
| | | |
| | | | |
What is it? | A small plastic and | A small plastic device | An injection that slowly | A small, flexible rod inserted |
| copper device which is | which is inserted into | releases progestogen | under the skin that slowly |
| inserted into the womb | the womb and slowly | | releases progestogen |
| | releases progestogen | | |
| | | | |
How does it work? | Prevents fertilization and | Mainly prevents | Prevents ovulation | Prevents ovulation |
| inhibits implantation of | implantation of egg | | |
| egg in the womb | and sometimes | | |
| | prevents fertilization | | |
| | | | |
How long does it | 5-10 years depending on | 5 years | Repeat injections every | 3 years |
last? | type | | 8-12 weeks depending on | |
| | | type | |
| | | | |
Chances of getting | Less than 2% of women | Less than 1% of | Less than 0.4% over a 2 | Less than 0.1% of women |
pregnant? | over a 5 year period | women over a 5 year | year period | over 3 year period |
| | period | | |
| | | | |
Could it affect | No | No | It may take up to a year | No |
chances of getting | | | for fertility to return to | |
pregnant in the | | | normal | |
future? | | | | |
| | | | |
Affect on periods? | Periods may become | For the first 6 months | Periods often stop, but | Period pains may improve. |
| heavier or more painful | there may be irregular | some women experience | Periods may stop, or |
| | bleeding or spotting. | irregular or persistent | become longer or irregular |
| | Periods often become | bleeding | until removal of implant |
| | less frequent or stop | | |
| | after a year | | |
| | | | |
Unwanted effects? | Risk of ectopic | Risk of ectopic | May gain weight (2-3kg | May develop acne |
| pregnancy is higher if a | pregnancy is higher if | over a year) | |
| woman falls pregnant | a woman falls | May cause thinning of the | |
| while using an IUD. | pregnant while using | bones which is reversible | |
| | an IUS. | on stopping | |
| | May develop acne | | |
| | | | |
Checks needed | Need check-up after first | The same checks | None – need to regularly | None. |
whilst using LARC | period after insertion. | apply as for the IUD. | receive repeat injections. | |
| Regularly feel for threads | See doctor or nurse if | See you doctor or nurse if | See you doctor or nurse if |
| of IUD to ensure it is still | you experience any | you experience any | you experience any |
| in place. | problems or want to | problems related to the | problems related to the |
| See doctor/nurse if you | have it removed. | injection. | implant, want to stop using it |
| experience any problems | | | or have it removed. |
| or want to have it | | | |