What's a LARC?
Finding the right contraception gives you the power to decide your future, manage your career, plan your family, and manage your health.
Australian women have had a long love affair with the Pill, which is a great option for many women, but we are falling behind the rest of the world when it comes to new options.
Long Acting Reversible Contraceptives (LARC) have been around for a long time, and have been rigorously refined and researched to ensure they are both safe and highly effective at preventing unintended pregnancy.
Long Acting Reversible Contraceptives last a lot longer than the Pill, but are completely reversible - you can chose to stop at any time, and you will return to your previous level of fertility.
Some women prefer LARC because they can last for up to 3, 5 or even 10 years at a time, are cost effective, avoid the potential for human error (ever forgotten to take your Pill on time?) and are very safe.
What are the options?
Your GP or Family Planning NSW doctor or nurse can help you decide on the method that suits you best - based on your medical history, lifestyle and personal preferences. Prior to commencing a LARC there will be an assessment of your health and suitability for different contraceptive methods. The practitioner will discuss the benefits and any side effects or disadvantages of the different options and encourage you to ask questions to help you decide which method you prefer.
The implant (Implanon NXT®) is a flexible rod that is inserted directly under the skin of the inner upper arm. It slowly releases a low dose of a progestogen hormone into the blood stream over a 3 year timeframe.
The contraceptive implant mainly works by preventing ovulation and is 99.9% effective. It is immediately reversible on removal.
Contraceptive implant insertion and removal involves a small procedure, with local anaesthetic, by a doctor or nurse trained in this procedure. Most GPs will be able to provide this service.
Intrauterine devices (IUDs)
IUDs can be hormonal or non-hormonal. The hormonal IUD (Mirena®) is a T-shaped plastic device inserted into the uterus, which slowly releases a very small amount of progestogen hormone into the uterus over a 5 year timeframe.
The hormonal IUD mainly works by thickening the mucus at the cervix and thinning the lining of the uterus. It is 99.8% effective.
The non-hormonal Copper IUD is a small device made from plastic and copper that is inserted into the uterus. They can last up to 5 or 10 years depending on the type of device.
The copper IUD mainly works by stopping sperm from fertilising the egg and affecting transport of the egg in the fallopian tubes. It also changes the lining of the uterus, making it less suitable for a pregnancy. It is 99.2 to 99.4% effective. IUD insertion is performed by a doctor or nurse who has been trained in this procedure. Devices need to be replaced every 5-10 years depending on their type. IUDs can be removed easily at any time by a health professional and are immediately reversible on removal.
Contraceptive injections: Depot Medroxyprogesterone Acetate (DMPA)
DMPA is given as an intramuscular injection every 12 weeks. The contraceptive injection mainly works by preventing ovulation. It is 99.8% effective when used perfectly but in typical use its effectiveness is lower than the other LARC methods (94%) because sometimes getting a regular injection on time can be challenging.
Contraceptive injections require a doctor's prescription. For some women return of periods and the previous level of fertility can take quite a few months after stopping.
Dispelling the myths
Despite the availability of great evidence-based information about LARC, there are still some myths and misconceptions flying around about different types of contraception, which may cause women to feel apprehensive about trying something different.
"I don't want to use something that will affect my fertility later on"
Implants and IUDs are immediately reversible on removal (fertility may take up to a year to return to normal after a contraceptive injection).
"It's not natural to skip your period"
The contraceptive implant, hormonal IUD and contraceptive injection may all result in reduced bleeding or even no bleeding at all. Many women welcome this change as it certainly cuts down on buying sanitary products. The copper IUD tends to make periods a bit heavier and last longer which may be acceptable for some women and not others.
"IUDs can't be used by young women or women who have not yet had children"
IUDs can be a suitable choice for women of all reproductive ages including young women who have not had children.
"It's not natural to have a device inside your body"
When it comes to contraception 'one size does not fit all' and having as many choices as possible available increases the chance of finding a method that suits you. What feels 'natural' to one woman may be different to what's 'natural' foranother.
Want to know more?
To learn more about LARC and find the right contraception for you, ask your GP or request an appointment at your nearest Family Planning NSW clinic today.
We also operate a confidential Family Planning NSW Talkline service on 1300 658 886
Visit our Advocacy page to learn about Family Planning Alliance Australia's position on LARC.