Let's learn about long-acting reversible family planning methods (LARC)?

Choosing a family planning method can sometimes feel like a hassle, right? You have to remember to take the pills every day, you have to get an injection every three months... With all these things, life can sometimes get hectic and you can forget about these things. So, would you like to know about a family planning method that you can forget about all this, use it once, and have peace of mind for years to come? We are talking about such a method today.

Simply put, what is LARC?

The English word LARC stands for Long-Acting Reversible Contraception . In simple Sinhala, it means "long-acting, reversible birth control methods". This is what the name means. Once you have these methods installed by your doctor, they provide protection from pregnancy for 3 to 10 years or even longer, depending on the type you choose.

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 child. Your fertility will return to normal as soon as it is removed. That's why it's called "reversible."

There are two main types of LARC methods:

Currently, the two most commonly used LARC methods in Sri Lanka and the world are intrauterine devices (IUDs) and implants.

How do these work inside the body?

Both of these devices essentially block sperm from reaching an egg, but the way they do this varies slightly depending on the type.

• Copper IUD: The copper in this creates an environment inside the uterus where sperm cannot survive. Specifically, it causes a slight inflammation that destroys sperm. It also thins the lining of the uterus (endometrium), so even if a sperm does somehow join an egg, it will not be able to implant in the uterus.

• Hormonal IUD: This creates a sperm-killing environment similar to the copper IUD. In addition, it releases a very small amount of a hormone (Levonorgestrel, a type of progestin). This hormone thickens your cervical mucus , making it harder for sperm to swim into the uterus. It also thins the uterine lining and partially stops ovulation in some women.

• Implant: This small device in your hand releases a hormone (Etonogestrel, a type of progestin) into your body. Its main function is to completely stop the release of an egg from the ovaries . In addition, the hormone, like the IUD, also thickens the cervical mucus.

What are the advantages of using a LARC method?

There are several reasons why many people prefer these methods.

• Very effective: These methods are more than 99% effective . If you take the pills exactly every day, it is also 99% effective. But we forget. Since there is no room for "forgetting" in these methods, in practical terms, these are the most effective methods.
• Less hassle: Once you get a doctor, you don't have to think about it for years. No need to remind yourself every day or go to the clinic every month.
• Saves money in the long run: Although it costs a little to install initially, this is an advantage in the long run as there are no other costs for many years.
• No barriers to sex life: There is freedom of mind because you don't have to suddenly think about birth control when having sex.

Other special advantages

• Some hormonal IUDs and implants can reduce heavy menstrual bleeding and pain . The Mirena IUD is also approved as a treatment for heavy bleeding.
• These also help reduce the pain caused by endometriosis.
• The copper IUD also works as an emergency contraceptive if inserted within 5 days of unprotected sex .

What are the situations when it is not a good idea to use these methods?

Although these are generally suitable for any healthy woman, there are some cases where their use is not recommended.

LARC methods are generally not recommended in the following cases:

• If you are already pregnant.
• If there is vaginal bleeding for no known reason.
• If you have cervical cancer or uterine cancer.
• If you currently have an active sexually transmitted disease (STI).

In addition, there are some special cases:

• The copper IUD is not suitable if you are allergic to copper or have Wilson's disease .
• If you have severe liver disease or breast cancer (or are at high risk for it), a hormonal IUD or implant is not suitable.
• If you have a history of blood clotting disorders, you should definitely discuss it with your doctor before getting an implant.

Are we also aware of side effects and complications?

As with any medical procedure, there are some minor side effects that can occur. But don't worry, most of the time these are not serious. The main thing is changes in your menstrual cycle.

These side effects are often more common in the first few months and decrease over time as the body gets used to it.

Some of the rare complications that can occur include the IUD slipping out of the uterus, puncturing the uterus during insertion (very rare), or developing an infection at the insertion site. Although these are rare, it's good to be aware of them.

Family planning, family planning, LARC, IUD, loop, implant, birth control, contraception, Mirena, Nexplanon, women's health