Long-acting reversible contraceptives

Long-acting reversible contraceptives (LARC)
Background
TypeVarious (includes hormonal and non-hormonal options)
First use?
Pregnancy rates (first year)
Perfect use?
Typical use?
Usage
ReversibilityYes
User reminders?
Advantages and disadvantages
STI protectionNo

Long-acting reversible contraceptives (LARC) are methods of birth control that provide effective contraception for an extended period without requiring user action. They include hormonal and non-hormonal intrauterine devices (IUDs) and subdermal hormonal contraceptive implants. They are the most effective reversible methods of contraception because their efficacy is not reliant on patient compliance. The failure rates of IUDs and implants is less than 1% per year.

LARCs are often recommended to people seeking convenient and cost effective contraception.[1] In one study, LARC users saved thousands of dollars over a five-year period compared to those who buy condoms and birth control pills.[2] LARCs can generally be safely and effectively used by people of any body weight,[3] adolescents,[4] and people who have not yet had children.[5][6]

In 2008, the American College of Obstetrics and Gynecologists (ACOG) launched The Long-Acting Reversible Contraception Program with the intention to reduce rates of unintended pregnancy by promoting LARCs, often referred to as a "LARC-first" model.[7] Rates of LARC use in the United States rose steadily in that time frame, from 3.7% in 2007 [7] to 10% in 2019.[8] LARC methods are most popular amongst people in their late teens and early twenties.[9] LARC use varies globally, with different regions reporting different use rates.[10][11] An estimated 161 million people of reproductive age use an IUD and an additional 25 million use an implant; this is 19.4% of the estimated global population of women of reproductive age.[12]

  1. ^ Stoddard, A.; McNicholas, C.; Peipert, J. F. (2011). "Efficacy and Safety of Long-Acting Reversible Contraception". Drugs. 71 (8): 969–980. doi:10.2165/11591290-000000000-00000. PMC 3662967. PMID 21668037.
  2. ^ Blumenthal, P. D.; Voedisch, A.; Gemzell-Danielsson, K. (2010). "Strategies to prevent unintended pregnancy: Increasing use of long-acting reversible contraception". Human Reproduction Update. 17 (1): 121–137. doi:10.1093/humupd/dmq026. PMID 20634208.
  3. ^ Baker, Courtney C.; Creinin, Mitchell D. (November 2022). "Long-Acting Reversible Contraception". Obstetrics & Gynecology. 140 (5): 883–897. doi:10.1097/AOG.0000000000004967. ISSN 0029-7844.
  4. ^ Diedrich, Justin T.; Klein, David A.; Peipert, Jeffrey F. (April 2017). "Long-acting reversible contraception in adolescents: a systematic review and meta-analysis". American Journal of Obstetrics and Gynecology. 216 (4): 364.e1–364.e12. doi:10.1016/j.ajog.2016.12.024. hdl:1805/14931. ISSN 0002-9378. PMID 28038902.
  5. ^ Baker, Courtney C.; Creinin, Mitchell D. (November 2022). "Long-Acting Reversible Contraception". Obstetrics & Gynecology. 140 (5): 883–897. doi:10.1097/AOG.0000000000004967. ISSN 0029-7844. PMID 36201766.
  6. ^ Cite error: The named reference :1 was invoked but never defined (see the help page).
  7. ^ a b Horvath, Sarah; Bumpus, Mica; Luchowski, Alicia (April 2020). "From uptake to access: a decade of learning from the ACOG LARC program". American Journal of Obstetrics and Gynecology. 222 (4): S866–S868.e1. doi:10.1016/j.ajog.2019.11.1269. ISSN 0002-9378. PMID 31794720.
  8. ^ "NSFG - Listing L - Key Statistics from the National Survey of Family Growth". www.cdc.gov. 6 November 2019. Retrieved 8 April 2024.
  9. ^ Kavanaugh, Megan L.; Pliskin, Emma (September 2020). "Use of contraception among reproductive-aged women in the United States, 2014 and 2016". F&S Reports. 1 (2): 83–93. doi:10.1016/j.xfre.2020.06.006. ISSN 2666-3341. PMC 8244260. PMID 34223223.
  10. ^ Joshi, Ritu; Khadilkar, Suvarna; Patel, Madhuri (October 2015). "Global trends in use of long-acting reversible and permanent methods of contraception: Seeking a balance". International Journal of Gynecology & Obstetrics. 131 (S1). doi:10.1016/j.ijgo.2015.04.024. ISSN 0020-7292.
  11. ^ Eeckhaut, Mieke C. W.; Sweeney, Megan M.; Gipson, Jessica D. (September 2014). "Who Is Using Long-Acting Reversible Contraceptive Methods? Findings from Nine Low-Fertility Countries". Perspectives on Sexual and Reproductive Health. 46 (3): 149–155. doi:10.1363/46e1914. ISSN 1538-6341. PMC 4167921. PMID 25040454.
  12. ^ "World Family Planning 2022: Meeting the changing needs for family planning: Contraceptive use by age and method | DESA Publications". desapublications.un.org. 23 December 2022. Retrieved 8 April 2024.