Long Acting Reversible Contraception (LARCs): birth control methods

Written by: Miss Christine Robinson
Edited by: Laura Burgess

The most effective form of contraception is collectively known as the Long-acting Reversible Contraceptives, or LARCs for short. There are four of these methods and expert our gynaecologist Miss Christine Robinson discusses each one.

What are the most effective forms of contraception?
The first is something called Depo-Provera, which is an injection inserted into the upper arm intramuscularly every 12 weeks. This is a method that has been around for a long time and is highly effective. It is becoming less popular now as the other methods have been produced.

The next method to consider is the intrauterine system with the most popularly-used being the Mirena. This is a plastic T-shape device that is inserted into the uterus and has progesterone on the downward stem which gradually infuses into the endometrium.

The copper intrauterine device is the next LARC method and these are usually T-shaped devices inserted into the uterus and they can last anywhere between 5 and 10 years depending on the device.

The final method is at the sub dermal implant called NEXPLANON®. This is a device that is about the size the small hair grip and is inserted with the use of local anaesthetic into the upper arm.

How effective are LARCs?
These are then the most effective four methods but they are not 100% effective. There is a wide variety of choice of really effective methods but if you’re looking for the most effective, go for the LARCs.

What happens during a consultation to choose the right contraceptive method?
When you go to see a professional for consultation of contraception, you should expect the person you see to be welcoming, caring and very ready to listen to what you have to say. The consultation should be unhurried. The specialist will need to ask some questions and will probably start with asking what form of contraception you are currently using, if you are and what you like about it and what you don’t.

It is important to look at the past gynaecological history and in particular the nature of the periods you have. Equally important are the questions about your sexual history as this is relevant to choosing one form of contraception or not. It is important, for example, if you have had chlamydia or similar, that this is discussed at this consultation.

Once the history has been taken and you have been given the opportunity to ask any questions or give any information which has not come to light, then it is usually appropriate to have an examination and this should be carried out with a chaperon present with your dignity respected and maintained throughout. Once all that is finished and you’re sitting back down again, the doctor should then put on the table as it were the methods of contraception from a medical perspective that would be suitable for you to consider.

What to look for in a specialist in contraception?
Approachability is really important and I would suggest that you look for the open access type of arrangement so if you have any problems, you can get back in touch with your specialist. Otherwise, a follow-up appointment is needed for contraception once it started so for example, for any intrauterine device is a follow up to six weeks will be appropriate and hormonal methods follow up at three months.

Fortunately, contraception is widely available. Pharmacies do provide services including the provision of condoms and some also can provide emergency contraception. If you’re looking towards a door or a nurse to provide you services, then it would be helpful to look to see if they’ve got a contraceptive qualification. So therefore, you can get services at your GP surgery at family planning clinics and sexual health clinics. Fortunately, therefore, the provision of contraception is widely available.

By Miss Christine Robinson
Obstetrics & gynaecology

Miss Christine Robinson is an experienced consultant medical gynaecologist based in Greater London. Specialising in all methods of contraception (including coils and implants), HRT and menopause, she is also an expert in the medical management of menstrual disorders and gynaecological hormone problems.

After training in gynaecology at major training hospitals such as St Thomas’s Hospital and St Mary’s Hospital in London and Addenbrooke’s Hospital in Cambridge, Miss Robinson developed one of the first medical gynaecology units in the UK. From 2008 until 2011 she was the President of the Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists where she led in the development of award-winning postgraduate educational training for specialists and GPs, and the production of national clinical standards ensuring the quality of care.

Furthermore, Miss Robinson's personal philosophy is to develop personalised, individual-centred care with each patient.

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