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Talk to your nurse or doctor to find out whether a LARC is suitable for you and to find out more about the process of getting a LARC. This is a free service for women. It requires an initial appointment to discuss options and a separate appointment for insertion of device, some LARCs also require a check 6 weeks after insertion.
Key points about long-acting reversible contraception
Long-acting reversible contraception is the most reliable form of contraception (birth control) available. You are able to get pregnant as soon as it is removed.
There are different forms of LARC. It can be an implant in your arm or a device that is inserted into your womb.
LARCs are called ‘fit and forget’ contraception because you don’t need to remember to take them every day.
LARCs don’t protect against sexually transmitted infections (STIs), so it’s still important to use condoms for safer sex.
Almost all women of any age can use LARC. Some forms of LARC are subsidised for women.
What are the long-acting reversible contraceptive choices?
There are four types of long-acting reversible contraception (LARC).
The contraceptive implant. (Jadelle) A minor procedure under local anaesthetic is needed to insert the small, rod-shaped implant under the skin in your upper arm, where it remains. The implant releases a progestogen hormone. Each implant lasts three years.
The contraceptive injection. (Depo Provera) An injection of a progestogen hormone is given every three months, most commonly into the muscle in your bottom.
The intrauterine contraceptive device (IUD Copper). This is also known as ‘the coil’. It sits inside the womb (uterus) and, once fitted, can stay in your womb for up to ten years. The device is called a coil because in the 1960s some devices were coil-shaped.
The intrauterine system (IUS -Mirena, Jaydess) This is a specific type of IUCD which releases a progestogen hormone into the womb. It can last for up to five years.
Contraceptive implants (Jadelle)
A contraceptive implant is a small device placed under the skin. It contains a progestogen hormone which slowly releases into the body. Around 1 woman in 2,000 using the implant will become pregnant each year. It involves a small minor operation. An injection of local anaesthetic is used to numb the skin. Each implant lasts three years, after which it should be removed.
Advantages
• It is very effective.
• You do not have to remember to take pills.
• They are reversible and periods return quickly once they are removed.
• Your periods tend to be very light or non-existent.
Disadvantages
• Periods may become irregular (but more often are lighter or stop altogether).
• Some women develop side-effects but these tend to settle after the first few months.
Intrauterine contraceptive device (Copper)
An intrauterine contraceptive device (IUCD) is also known as a coil. A plastic and copper device is put into the womb (uterus). It lasts for five or more years. Between 6 and 8 women in 1,000 will become pregnant in one year of use of this method.
Advantages
• It is very effective.
• You do not have to remember to take pills.
• It lasts a long time – 5-10 years.
• There are no hormones, so there are no side-effects due to hormonal changes in your body.
Disadvantages
• Your periods may become heavier or more painful.
• There is a small risk of serious problems.
• It is uncomfortable having the coil put in. (However, this is only once in 5-10 years.)
• They do not provide protection against sexually transmitted infections.
Intrauterine system (Jaydess, Mirena)
With the intrauterine system (IUS), a plastic device that contains a progestogen hormone is put into the womb (uterus). The progestogen is released at a slow but constant rate. Around 1-2 women in 1,000 will become pregnant in one year of use of this method. The IUS is also used to treat heavy periods (menorrhagia).
Advantages
• It is very effective.
• You do not have to remember to take pills.
• Periods become light or stop altogether.
Disadvantages
• Side-effects may occur as with other progestogen methods such as the POP, implant and injection. However, they are much less likely, as little hormone gets into the bloodstream.
• It is uncomfortable having it put in and does not last as long as the other type of coil.
Contraceptive injections (Depo Provera)
Contraceptive injections contain a progestogen hormone which slowly releases into the body. They are very effective. Between 3 and 60 women in every 1,000 using it will become pregnant. An injection is needed every 12 weeks.
Advantages
• They are very effective.
• You do not have to remember to take pills.
• Once your body is used to the hormone, you often have no periods or very light periods. Particularly if you had heavy or painful periods, this is an advantage.
• You can have contraceptive injections whilst breastfeeding.
Disadvantages
• Periods may become irregular (but often lighter or stop altogether).
• After stopping, there may be a delay in your return to normal fertility for several months. It may take up to a year for your period to come back.
• Some women have side-effects. Common side-effects are gaining weight, mood changes and headaches. You cannot undo the injection, so if side-effects occur they may continue for longer than 8-13 weeks.
• The injections cause a very slight thinning of your bones.
• There may be a very small increase in the risk of breast cancer and cancer of the neck of the womb (cervix).
Reference: Sexual Wellbeing Aotearoa
