Long acting reversible contraceptives
Clearinghouse Connector – October 2015
Links to online resources available from the Women’s Health Victoria Clearinghouse collection.
To access these resources follow the title hyperlink. The display includes a link to the external website where the full text is available.
Need information on a different topic? Check out our Clearinghouse Connector archive.
Long acting reversible contraceptives (LARC) are methods of contraception that require administration less than once per month, can be removed or ‘reversed’, and should not affect long-term fertility. The term LARC usually refers to contraceptive implants (in Australia available as Implanon NXT®) which are inserted under the skin and provide contraceptive coverage for up to 3 years, and copper and hormonal intrauterine devices (IUDs) inserted into the uterus, which can be effective for up to 5-10 years.
LARC methods have few contraindications, are cost effective over time, and are generally appropriate for use by women of all ages. IUDs and implants are among the most effective forms of reversible contraception available.
Other benefits are associated with the use of LARC, especially for young women and those experiencing sexual and/or reproductive coercion. These include that following insertion, it is harder (though not impossible) for someone else to tell if you are using LARC methods. In addition, these contraceptives can be inserted immediately after an abortion or miscarriage, or while breastfeeding. The copper IUD is also extremely effective as emergency contraception. However, no form of contraception is 100 per cent effective or free from side-effects. While LARC methods are extremely effective in preventing pregnancy, unlike condoms they do not prevent sexually transmissible infections (STIs).
Despite the benefits of LARC methods compared with other forms of contraception, current uptake in Australia remains low (with recent studies indicating that less than 10 per cent of women in Australia use LARC methods). A shift towards prescribing LARC, as recommended in clinical guidelines, has yet to occur in Australian general practice. Doctors may be reluctant to prescribe these types of contraceptives because of uncertainty about their suitability, or due to a lack of training on insertion. Additional barriers for women accessing LARC methods include concerns around possible side-effects, and the initial cost. Greater understanding by GPs of the attitudes, experiences and concerns of women in relation to LARC methods could lead to more effective contraceptive use and more meaningful choice for women.
Additional research is required relating to the uptake and experiences of LARC methods by women with disabilities and Aboriginal women, acknowledging that contraceptive interventions occur within a social and historical context which has included state-sanctioned reproductive coercion, including forced contraception. Strategies for increasing LARC access should ensure that options for specific populations are not restricted, and that reproductive choice for all women is promoted.
Overview of different types of LARC
Your contraception choices The Royal Women’s Hospital (available in a number of languages), 2015
Contraception: It’s your choice Family Planning Victoria, 2015
Long-acting reversible contraception (LARC): IUD and implant American College of Obstetricians and Gynecologists, 2014
Uptake and barriers
Few Australian women use long-acting contraceptives, despite their advantages The Conversation, 2015
Victorian Rural Women’s Access To Family Planning Services Survey report Project of the Rural Services of the Women’s Health Association of Victoria, 2012
Factors predicting uptake of long-acting reversible methods of contraception among women presenting for abortion The Medical Journal of Australia, 2014
Menstrual manipulation for adolescents with disabilities American College of Obstetricians and Gynecologists, 2009
Common threads : the sexual and reproductive health experiences of immigrant and refugee women in Australia Multicultural Centre for Women’s Health (MCWH), 2012
Long acting reversible contraception, young women and social norms Centre for Public Health, Liverpool John Moores University, 2014
Leveling the playing field : the promise of long-acting reversible contraceptives for adolescents Guttmacher Policy Review, 2013
Victorian GPs being trained to discuss with women long term contraceptive implants The Age, January 2015
Contraception and substance use : practical advice for women The Royal Women’s Hospital, 2014
Long acting reversible contraception position statement Family Planning Alliance Australia, 2014
Use by young women
Long-acting reversible contraception for adolescents Current Opinions in Obstetrics and Gynecology, 2015
Factors associated with contraceptive satisfaction in adolescent women using the IUD Journal of Pediatric and Adolescent Gynecology, 2015
Understanding the low uptake of long-acting reversible contraception by young women in Australia : a qualitative study BioMed Central Women’s Health, 2015
Resources for health professionals
Long acting reversible contraception The Royal Australian and New Zealand College of Obstetricians and Gynaecologists, 2014
Effectiveness of long acting reversible contraception New England Journal of Medicine 2012
Game change in Colorado : widespread use of long-acting reversible contraceptives and rapid decline in births among young, low-income women Perspectives on Sexual and Reproductive Health, 2014
The impact on women’s health of climatic and economic disaster : position paper Australian Women’s Health Network (AWHN), 2014
Women or LARC first? : reproductive autonomy and the promotion of long-acting reversible contraceptive methods Perspectives on Sexual and Reproductive Health, 2014
Common threads, common practice : working with immigrant and refugee women in sexual and reproductive health : best practice guide Multicultural Centre for Women’s Health, 2012
Current contraceptive management in Australian general practice : an analysis of BEACH data The Medical Journal of Australia, 2012
Contraception : common issues and practical suggestions Australian Family Physician, 2012
Promoting the use of long-acting reversible contraceptives Austin Journal of Obstetrics and Gynecology, 2014
Who is using long-acting reversible contraceptive methods? : findings from nine low-fertility countries Perspectives on Sexual and Reproductive Health, 2014
Injectable contraception provided by community-based health workers : one important step toward meeting unmet need Global Health, Science and Practice, 2013
Trends in long-acting reversible contraception use among U.S. women aged 15-44 National Centre for Health, 2015
The continuation rates of long-acting reversible contraceptives in UK general practice using data from The Health Improvement Network Pharmacoepidemiology and Drug Safety, 2015
RISUG: an intravasal injectable male contraceptive The Indian Journal of Medical Research, 2014
How our Clearinghouse can help you
Women’s Health Victoria’s Clearinghouse has a wealth of information on gender in health in various forms. Our experienced health and information professionals can assist you to access this information.
Feedback and subscription
We value your feedback. Please tell us what you think of this resource. Click here to take a brief online survey
Please Contact Us with any feedback including suggestions for future Clearinghouse Connector topics.
Has a colleague forwarded this e-bulletin to you?
For your own subscription, complete an online Subscribe Request.