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Long acting reversible contraception (LARCs)

by Dr Jessica Smith - December 12, 2017

Gone are the days when the pill was the only method of contraception available. We now have methods that are more reliable, and are referred to as ‘set and forget’. Long-acting reversible contraceptives (LARC) provide contraception for an extended period without the need for user action. 

Progesterone implant

contraceptive implant

The implant is inserted just under the skin and lasts for 3 years. It is 99.8% reliable, compared to the oral contraceptive pill which is 91% reliable. It involves a minor surgical procedure where a doctor uses a small amount of local anaesthetic under the skin to numb the area prior to insertion. As progesterone is a hormone, it can alter a woman’s periods.

  • 1 in 5 women will have no periods
  • 3 in 5 will have a degree of spotting to moderate bleeding which is often irregular
  • 1 in 5 women will have heavy periods, and require further management by their doctor. This usually settles after 3 months

Common side effects include breast tenderness, headaches, mood and skin changes, but not all women experience these.

Intra-uterine device (IUD)

An IUD is a device that is inserted into the uterus. There are 2 types:

  1. Copper: a copper coil wraps around the device which acts to kill sperm. The device itself agitates the lining of the uterus, preventing any fertilised egg from implanting. A copper IUD can last up to 10 years. As there is no hormone, many women prefer this option due to the reduced risk of hormone based side effects (breast tenderness, mood and skin changes, headaches). Periods are often heavier.
  2. Progesterone: IUDs with progesterone imbedded into the device act to thin the uterine lining. They are utilised for contraception, but also for women with chronic pelvic pain or heavy periods from conditions such as endometriosis. Most women experience much lighter periods, or no periods at all. They are effective for 5 years for contraception. They are often changed at 3 years for women with pelvic pain.

So why do we like them?

They are more reliable, and don’t depend on you remembering to take a tablet every day. For many, there are the additional benefits of improved period pain and bleeding control. Both require a procedure for insertion, and is best discussed with a doctor who is accredited in insertion.

Globe Medical has 2 GPs accredited to insert progesterone IUD’s (Dr Jessica Smith and Dr Jane Allen) and several GPs accredited in implant insertion. 

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Dr Jessica Smith

Dr Jessica joined Globe Medical in mid-2016 as a General Practitioner. In a short space of time Jess has developed a strong following of female patients who appreciate Jess' soft demeanour, supportive nature and strong interest in women's and sexual health. Jess is accredited for implanon & IUD insertion and holds a Certificate in Sexual and Reproductive Health (Shine SA)

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