Are you aware of LARC (Long-Acting Reversible Contraception)? Let's talk about it!

Do you also have trouble remembering to take your family planning pill every day? Or do you sometimes miss the injection you need to take every three months? If you are thinking of postponing having a child for a while, what do you think about a method that can be used once and used for years without any worries? That is the method we are going to talk about today.

What is LARC? Simply put...

LARC stands for long-acting reversible contraception . This is an abbreviation for ``Long-Acting Reversible Contraception''. Simply put, once inserted by your doctor, these provide protection against pregnancy for three to ten years, or even longer, depending on the type you use.

These come in two main types. One is a device that a doctor places inside your uterus. The other is a small device that is placed under the skin of your arm. One of the biggest advantages of these methods is that you can remove the device at any time if you decide you want to have another baby. After it is removed, your fertility will return to normal.

What LARC methods are there?

As we discussed earlier, there are two main types of LARC methods: intrauterine devices (IUDs) and implants.

Intrauterine devices (IUDs)

An IUD (Intrauterine Device) is a small plastic device shaped like the letter 'T' that your doctor inserts into your uterus. There are two main types: copper-containing IUDs and hormonal IUDs.

Implant

This is a flexible plastic implant about the size of a matchstick. Your doctor will insert it under the skin on the inside of your upper arm. The most commonly used type in Sri Lanka and around the world is called `Nexplanon®`. It provides protection for up to three years.

See the table below for a simple understanding of these methods.

How effective are these methods really?

LARC methods are one of the most effective birth control methods available. They are over 99% effective. Imagine, out of 100 women using this method, the chance of getting pregnant in a year is less than one.

Family planning pills are 99% effective if taken exactly every day. But the problem is that we sometimes forget to take the pill. With such forgetfulness, the actual effectiveness of the pills drops to about 91%. But when you use an IUD or an implant, you don't have to remember to take it every day, so there is no risk of forgetting. That's why their effectiveness is very high.

Who is LARC suitable for? Who is it not suitable for?

Who are these best for?

If you're looking for a hassle-free, long-term method of preventing pregnancy, LARC methods may be a good fit for you. In particular,

• If you forget to take your daily pills.
• If you have a hard time finding the time to go get injections every few months.
• If you are someone who currently has no plans to have children, but thinks they might want one in the future.

Simply put, this is a good option for anyone looking for a "set it once and forget about it for years" solution.

When not to use these methods

There are some health conditions in which it is not appropriate to use an IUD or implant. Your doctor will examine you and advise you about this. These are usually not recommended:

• If you are already pregnant.
• If there is vaginal bleeding for no apparent reason.
• If you have cervical cancer or uterine cancer.
• If you currently have a sexually transmitted infection (STI).

Additionally, some LARC types are not suitable for people with specific medical conditions.

• Copper IUD: This is not suitable if you have an allergy to copper or Wilson's disease.
• Hormonal IUD or Implant: These are not suitable if you have severe liver disease or breast cancer (or are at high risk for it).

If you have a history of blood clots, be sure to talk to your doctor about it before getting an implant.

How do these work inside the body?

These devices create an environment in the uterus where sperm cannot survive, preventing them from traveling to the fallopian tubes and fertilizing an egg.

• Copper IUDs: These cause a mild inflammation in the uterus. This is not harmful to the body, but this environment is toxic to sperm. They also thin the lining of the uterus, making it less likely that an egg will implant in the uterus, even if it is fertilized.
• Hormonal IUDs: These also trigger an immune response like the copper IUD. In addition, they slowly release the progestin hormone levonorgestrel. This hormone thickens cervical mucus, making it harder for sperm to swim up. It also thins the uterine lining and prevents ovulation (the release of an egg) to some extent.
• Implants: These also release the progestin hormone etonogestrel. Their main function is to stop you from ovulating completely. Like the hormonal IUD, they also thicken your cervical mucus.

What are the side effects and complications of LARC methods?

Like any birth control method, LARC methods can cause some side effects. But these are usually not serious. The main one is that they can cause changes in your menstrual cycle. What these changes are will depend on the type you use.

Let's also learn about complications.

LARC methods are very safe, and complications are rare . If they do occur, the following may occur:

• The IUD may slip out of the uterus (especially in the first few months).
• Perforation of the uterine wall during insertion of the IUD (this is very rare).
• The implant may come out of its place of placement (often due to improper placement or infection).
• Infection after the device is placed.

No matter how successful these methods are, if a pregnancy occurs very rarely, it is considered a high-risk pregnancy.

Family Planning, LARC, IUD, Implant, Birth Control, Mirena, Nexplanon, Women's Health