Long-acting reversible contraception (LARC)

Long-acting reversible contraception is the most reliable form of contraception available. You are able to get pregnant as soon as it is removed.

Key points about long-acting reversible contraception (LARC)

  1. There are different forms of LARC. It can be an implant in your arm or a device that is inserted into your womb.
  2. LARCs are called ‘fit and forget’ contraception because you don’t need to remember to take them every day.
  3. However, LARCs don’t protect against sexually transmitted infections (STIs), so it’s still important to use condoms for safer sex.
  4. Talk to your nurse or doctor to find out whether a LARC is suitable for you.

What is long-acting reversible contraception (LARC)?

Long-acting reversible contraception are methods of preventing pregnancy that can last for a long time and are reversible. This means 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 (uterus).

There are 2 types of LARC in Aotearoa New Zealand:

  • the implant – currently this is the Jadelle 
  • the intrauterine method, which includes an intrauterine system (IUS) and an intrauterine device (IUD).

They are called 'fit and forget' contraception because you don’t need to remember to take them every day.

Who is LARC suitable for?

Almost all women of any age can use LARC. Some forms of LARC are subsidised, so you only need to pay for your clinic appointment and the cost of fitting and removing it.

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.

What are the pros and cons of LARC?

Pros Cons

✔ You don’t have to remember to take anything every day – LARCs can last for many years once inserted into your body. 

✔ They are highly effective and reliable at preventing pregnancy.

✔ You can get pregnant immediately if you wish once a LARC is removed.

✔ No follow-up is required once a LARC is inserted unless problems occur.

✘ They don't protect against STIs, so it’s still important to use condoms for safer sex.

✘ You need a small procedure for a LARC to be implanted or inserted.

What is the contraceptive implant?

The contraceptive implant, which releases the hormone progestogen, is made up of 2 small rods (each about the size of a matchstick). It is inserted under the skin of your upper arm. It works by making your cervical mucus thicker so sperm can’t travel through it. The contraceptive implant may also stop your ovaries releasing an egg.

Insertion and removal of the implant has to be done by your healthcare provider. It's more reliable than sterilisation (tubal ligation) and is immediately reversible. This means you are able to get pregnant as soon as it is removed.

The contraceptive implant currently available in Aotearoa New Zealand is the Jadelle. It can last for 3–5 years once inserted. It doesn't provide any protection against STIs, so it is still important to use condoms for safer sex. The most common side effect of the implant is irregular bleeding patterns.

Chance of getting pregnant: less than 1% (less than 1 pregnancy in every 100 people using an implant for 1 year).

Read more about the contraceptive implant.

What is the intrauterine method?

The intrauterine method uses a small object (device) that is placed inside your uterus (womb). The device can either contain copper or a progestogen hormone similar to one produced by your ovaries. Intrauterine devices or systems must be fitted by your doctor or nurse. They don’t provide any protection against STIs, so it is still important to use condoms for safer sex.

There are 2 main types of intrauterine method:

  • intrauterine contraceptive device (IUD)
  • intrauterine system (IUS).

Intrauterine contraceptive devices (IUDs, IUCDs, coils, loops)

An intrauterine contraceptive device is a small plastic and copper object that is placed in your uterus (womb). IUDs don’t contain any hormones. They have a small nylon ‘tail’ that comes out through the opening of your womb. This is used to remove the device.

These devices work by stopping sperm meeting with your egg. They may also stop a fertilised egg from burying itself in your womb lining to grow.

They are usually changed every 5–10 years. They can also be used as an emergency contraception up to 5 days after unprotected sex.

The most common side effect of using an IUD is that your periods may become longer or heavier. There is a small risk of pelvic infection when the IUD is inserted, so it should not be inserted if you have symptoms of a genital or pelvic infection such as vaginal discharge or lower tummy pain. If you become pregnant with an IUD in, see your doctor immediately.

Chance of getting pregnant: 1% (1 pregnancy in every 100 people using an IUD for 1 year).

Intrauterine systems (IUS) or hormonal IUDs

An intrauterine system is a small plastic object that is placed in your uterus (womb) where it then releases a hormone (progestogen). It makes your womb lining thinner and your cervical mucus thicker, so that sperm can’t meet with your egg and a fertilised egg can’t bury in your womb lining.

They can last for 3–5 years once inserted or longer in some situations as advised by your doctor. An IUS is suitable if you have heavy periods because while using it your periods are often much lighter or stop completely. They are also used as a treatment for menorrhagia (heavy periods).

There are 2 different IUSs used in New Zealand: Mirena and Jaydess.

Chance of getting pregnant: less than 1% (less than 1 pregnancy in every 100 people using an IUS for 1 year).

Read more about intrauterine contraceptive devices.

Learn more

The following links provide further information about long-acting reversible contraception. Be aware that websites from other countries may have information that differs from New Zealand recommendations.   

Long-acting reversible contraception Family Planning New Zealand
Long-acting reversible contraceptives Patient Info, UK 

References

  1. New Zealand Aotearoa’s guidance on contraception Ministry of Health, NZ, 2020
  2. Long-acting contraceptives: implants and IUDs BPAC, NZ, 2019

Reviewed by

Dr Alice Miller trained as a GP in the UK and has been working in New Zealand since 2013. She has undertaken extra study in diabetes, sexual and reproductive healthcare, and skin cancer medicine. Alice has a special interest in preventative health and self-care, which she is building on by studying for the Diploma of Public Health with the University of Otago in Wellington.
Credits: Health Navigator Editorial Team. Reviewed By: Dr Alice Miller, FRNZCGP, Wellington Last reviewed: 24 Mar 2021