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Long Acting Reversible Contraception

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By Dr Helen Webberley MBChB MRCGP MFSRH | GMC no. 3657058

I am an NHS GP and a sexual health and hormone specialist. I can give advice on any medical matter, and I offer safe access to medical advice, prescription medication, blood tests and x-rays, and specialist referrals to your local private hospital as needed.

LARCS long acting reversible contraception

The most effective methods at preventing a pregnancy- as effective or better than female sterilisation. Fitted/administered by a suitably trained health professional.

Fertility returns after removal, usually immediately except for the contraceptive injection.

Also referred to as ‘forgettable’ methods as little or no input is required by the user

This group includes Intra uterine contraception, Implant and injection

Frequently Asked Questions

Who can’t use an Intra uterine methods?
An intrauterine device may not be suitable for woman with a known intrauterine abnormality for example a bicornute uterus ( heart shaped womb) and some types of fibroids. Some women may require an ultrasound scan or further investigations prior to an intrauterine device being fitted.

Information about keeping sexually healthy are usually discussed at a pre-fitting consultation, along with the risks and benefits of the method

What are the common side-effects?
  • Minor/nuisance side-effects can occur with any hormonal method and may include, headaches, skin changes, nausea, increased appetite which can lead to weight gain, tender breasts, bloating. Symptoms often settle within the first 2-3 months of use.
  • IUCD – copper coil does not have any hormonal side-effects but can make periods heavier
Are any tests needed?
A medical history is required before starting LARC methods and a risk assessment for sexually transmitted infections is usually discussed
What tests do we offer?
  1. Basic Chlamydia/gonorrhoea urine test
  2. Test for 7 infections- Chlamydia, Gonorrhoea, Mycoplasma Genitalium, Ureaplasma, Trichomonas  vaginalis, Herpes Simplex 1/11 and Gardnerella vaginalis
  3. Blood tests- HIV, Syphilis, Hepatitis B, Hepatitis C

What types of intra uterine contraception are available?

IUCD, copper coil

  • Only non- hormonal LARC
  • small plastic device with copper, usually ‘T’ shaped
  • It is 99% effective
  • It is placed in the uterus (womb) via the vagina.
  • Changes the environment within the womb so that sperm cannot survive.
  • Also prevents implantation of a fertilised egg by acting as a foreign body in the womb
  • Effective for 5-10 years dependant on the type of device used.
  • Periods can be heavier and sometimes more painful.
  • Once removed fertility returns instantly to whatever it would have been.

Intra uterine system (IUS, Mirena, Jaydess)

  • As effective as female sterilisation
  • small ‘T’  shaped plastic device with an attached progesterone releasing hormone.
  • It is placed in the uterus (womb) via the vagina
  • Works by stopping the endometrium (lining of the womb) developing every month ready to support a pregnancy and makes a plug of mucus at the neck of the womb so it is difficult for sperm to enter the womb
  • Lasts for 3-5 years dependant of device used

Intra uterine system – Extra Info

  • IUS causes a change in periods often stopping periods or bleeding becomes much lighter. Irregular bleeding may occur for the 1st 3-6 months
  • IUS is licensed for use to help women who have heavy periods as long as any abnormal cause for the bleeding has been ruled out
  • IUS is also licensed for use as the progesterone part of Hormone replacement Treatment, when oestrogen can be added via pills, patch or gel.
  • Jaydess is a device that is smaller than an IUS and contains less progesterone hormone . Women usually experience periods of normal loss or some irregular bleeding. Lasts up to 3 years

Other LARC Methods

Contraceptive implant (Nexplanon)

  • Most effective method of female contraception available, and more effective than female sterilisation.
  • Small match size device inserted under the skin of the upper arm by a suitable trained health professional. Lasts for up to 3 years with no follow up required unless the woman is having any concerns
  • Releases a small daily dose of progesterone, stops ovulation
  • On average 20% of women stop having periods, 30% have regular periods or occasional bleeding, 50% have irregular and/or prolonged bleeding. This is the most common reason that women request early removal
  • Once removed fertility returns to whatever it would have been

Contraceptive injection, Depo-Provera, Sayana Press

  • As effective as female sterilisation
  • Stops ovulation
  • Usually required every 12 weeks
  • Sayana Press is a newer self administered injection
  • On average 70% of women stop having periods, the remaining 30% may have unpredictable bleeding patterns
  • May cause weight gain – research shows the average gain is 3.5kgs in the first 12 months of use and then weight gain risk is the same as any other hormonal method
  • After stopping the method it can take up to 12 months for periods to return regularly and for fertility to return

Safe, real prescriptions to help you

Whether you know what treatment works for you or you need advice on what you should take,

ask me here about safe prescriptions to help with your condition.

Tests

We can offer three packages for sexual health screening

Package 1

Basic Chlamydia/gonorrhoea urine test

Package 2

Test for 7 infections- Chlamydia, Gonorrhoea, Mycoplasma Genitalium, Ureaplasma, Trichomonas vaginalis, Herpes Simplex 1/11 and Gardnerella vaginalis

Package 3

Blood tests- HIV, Syphilis, Hepatitis B, Hepatitis C

Contact me now for advice, prescriptions, blood tests and referrals.

Please note that this service does not aim to replace advice given to you by your own doctor, it is meant to supplement your health knowledge and awareness.

It is never to be used in the case of a medical emergency.

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