There are many long-acting reversible contraceptives (LARCs) which are available for women and can last for weeks, months, and even years. Each of the LARCs requires little effort once they are inserted, and can protect unwanted pregnancy up to almost twenty times better than short-term contraceptive options such as birth control pills, patches, and vaginal rings (Planned Parenthood, 2018).
LARCs are an excellent option for women who would like to become pregnant in the future or would still like to keep their fertility, yet require long-term and reliable pregnancy prevention. LARCs include the copper (ParaGard) IUD, the hormone (Mirena) IUD, and the hormonal contraceptive implant. Each of these methods is effective for years. They have been proven to be safe and are highly effective even in women who have never previously given birth.
It is important to keep in mind that like many other birth control methods, LARCs cannot protect against sexually transmitted diseases and infections. As condoms are a form of barrier contraception, they can protect against infections and diseases being passed between sexual partners.
LARCs can only be obtained from your doctor or a family planning clinic, as patients must attend two appointments before an IUD or an implant can be fitted. This is to ensure that the patient and doctor can have a detailed discussion about the advantages and disadvantages of the LARC in question and so that the patient can ask any questions they have. The doctor will also discuss the patient’s general and reproductive health.
Women are asked to arrange their second appointment sometime during their menstrual cycle so that the doctor can confirm they are not already pregnant. The doctor can then administer the LARC. During the appointment, the doctor should also advise how to recognise any side effects of the LARC and how to deal with them. Any further check-ups that the patient may need during the use of the contraceptive can also be arranged or discussed at this point.
The contraceptive implant is inserted underneath the skin of the inner, upper arm and can usually provide up to three years of protection against pregnancy.
It is made of plastic and contains the hormone progesterone which is continuously released. Progestogen prevents ovulation occurring each month which means that there is no egg available for fertilisation. The hormone also acts by changing the mucus that is produced within the cervix, so that it is more difficult for sperm to enter the uterus.
Sometimes side effects can occur. These include weight gain, breast tenderness, or changes in periods. All of the potential side effects are caused by the hormone progestogen.
IUD is short for ‘intra-uterine device’. These are small T-shaped devices which are placed within the uterus. IUDs have a small string which remains attached once it is inserted in the patient, and left to pass out through the cervix.
The purpose of the string is so the patient can feel for it to ensure the device is still in place. It is also helpful for removing the device. Insertion of the IUD is usually straightforward; however, it is likely that patients will experience some cramping for a few days after the IUD has been inserted.
There are two types of IUDs available, which each have their advantages and disadvantages;
The hormone (Mirena) IUD;
This IUD releases the hormone progestogen and can provide continuous contraception for up to five years. This is the same hormone which is found in the implant; therefore the methods of pregnancy protection and side effects are similar.
The copper (ParaGard) IUD;
This IUD device has a fine copper wire wound around the stem and can provide continuous contraception for five to ten years. The copper IUD works by releasing a small amount of copper.
This copper creates a condition inside the uterus making it unsuitable for sperms and eggs to move and also prevents the implantation of any fertilised eggs. Some women may find that periods can become heavier and longer than they were previously; however, this symptom often settles within a few months of having the IUD in place. As there are no hormones involved, the copper IUD usually has little to no other side effects.
To learn more about long-term contraception and which option may be suitable for you, speak to your doctor or a family planning nurse for more information.