Reviewed by a GPhC-registered Pharmacist at Newdays Pharmacy
Quick Answer: Long Acting Reversible Contraception (LARC) refers to methods that provide effective contraception for months or years without requiring daily attention. Options include the contraceptive implant (Nexplanon), the contraceptive injection (Depo-Provera), the copper intrauterine device (IUD), and the hormonal intrauterine system (IUS, for example Mirena). All are highly effective, over 99%, and fully reversible.
What Is Long Acting Reversible Contraception (LARC)?
LARC methods are forms of contraception that last for an extended period (from eight weeks to ten years depending on the method) and require no daily action from the user once in place. The UK Faculty of Sexual and Reproductive Healthcare (FSRH) recommends LARC as highly cost effective and some of the most reliable forms of contraception available.
All LARC methods are reversible: fertility typically returns promptly after removal or discontinuation. They do not have a long term impact on future fertility.
The Contraceptive Implant (Nexplanon)
The contraceptive implant is a small, flexible plastic rod (approximately four centimetres long) inserted under the skin of the upper arm under local anaesthetic. In the UK, the available brand is Nexplanon.
- Duration: Up to three years
- Hormone: Etonogestrel (progestogen only, no oestrogen)
- Effectiveness: Over 99%
- How it works: Primarily by preventing ovulation and thickening cervical mucus
- Side effects: May cause irregular periods or absence of periods (amenorrhoea); some users report headaches, acne, or mood changes
- Suitable for: Women who cannot take oestrogen; those who want long term contraception without daily effort
The Contraceptive Injection (Depo-Provera / Sayana Press)
The contraceptive injection delivers progestogen into a muscle (intramuscular, Depo-Provera) or under the skin (subcutaneous, Sayana Press) every twelve to thirteen weeks.
- Duration: Twelve to thirteen weeks per injection
- Hormone: Medroxyprogesterone acetate (progestogen only)
- Effectiveness: Over 99% with perfect use
- Important consideration: Fertility may take twelve to eighteen months to return after stopping. This method is not ideal if you may want to conceive in the near future
- Side effects: Irregular periods or no periods; bone mineral density reduction with long term use (usually reversible)
The Copper IUD (Intrauterine Device)
The copper IUD is a small T shaped plastic frame wrapped in copper wire, inserted into the uterus by a trained clinician. It releases no hormones.
- Duration: Five to ten years depending on type
- Hormones: None; a non hormonal method
- Effectiveness: Over 99%: the most effective LARC method available
- Also used as: Emergency contraception (if inserted within five days of unprotected sex)
- Side effects: May cause heavier, more painful periods; not suitable for women with already heavy periods or fibroids
- Suitable for: Women who cannot or prefer not to use hormonal contraception; those wanting the most effective non hormonal option
The Hormonal IUS (Intrauterine System – Mirena, Kyleena, Jaydess)
The hormonal IUS is similar in shape to the copper IUD but releases a small amount of levonorgestrel (progestogen) locally into the uterus.
- Duration: Three to eight years depending on brand (Mirena: eight years; Kyleena: five years; Jaydess: three years)
- Hormone: Levonorgestrel (locally released, with very low systemic absorption)
- Effectiveness: Over 99%
- Additional benefit: Often significantly reduces period pain and flow; licensed for treatment of heavy menstrual bleeding and endometriosis
- Side effects: Irregular spotting initially; many users experience lighter or absent periods after the first few months
How to Access LARC in the UK
IUD and IUS insertion must be performed by a trained clinician at a GP surgery, sexual health clinic, or specialist service. Contraceptive implants and injections may also be available at some GP practices and sexual health clinics.
Newdays Pharmacy offers consultations on all contraceptive options including LARC, can help you understand your choices, and can direct you to appropriate local services for procedures. We provide ongoing contraceptive consultations and supplies.
Book Now: Book a Contraception Consultation
Clinical Disclaimer: This article is intended for general information only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any treatment or medication. Information is accurate as of the date of publication and reviewed by a GPhC-registered pharmacist. Newdays Pharmacy is registered with the General Pharmaceutical Council (GPhC).
Frequently Asked Questions
No. All LARC methods are fully reversible. Fertility typically returns quickly after removal of the implant, IUD, or IUS. The contraceptive injection is the exception: it may take twelve to eighteen months for fertility to return after the last injection.
You may be able to feel the implant under the skin if you press on the area, but it should not cause pain or be visible. It should not be felt in any other circumstances.
Most people experience cramping during and shortly after insertion, similar to strong period pain. Pain relief (such as ibuprofen taken before the appointment) is usually recommended. The procedure typically takes a few minutes.