Long Acting Reversible Contraceptive Methods  (LARC)

These methods of Contraception should be discussed with all clients wishing to avoid Pregnancy. These methods of contraception last from 3-5 years and do not involve swallowing pills etc.

Implanon, the contraceptive implant

Implanon is a little rod, which can be inserted into your arm just under the skin.It is about the size of a match and once inserted you are able to feel it but it is not visible. This little rod produces a low dose of Hormone slowly releasing it into the tissue below your skin. This stops you ovulating (releasing an egg). It also alters the Cervical mucus. Almost everybody can have this method of contraception and is has an extremely low failure rate. This method of contraception once in your arm can stay in for 3 years. The insertion of the implant involves a small amount of local Anaesthetic in your arm but there are no stitches and you do not require to be put to sleep. The area on the arm is bandaged for 48 hours to reduce swelling. If you think you would like an implant inserted, you would be counselled fully about the benefits and side effects before it is inserted.

The Mirena Contraceptive Device (IUS)

The Mirena is an intra Uterine system.  This means it is like a coil in that it is fitted into the Uterus (womb). It contains a very low dose of Progestogen hormone which acts locally inside the uterus (womb).  This prevents pregnancy by altering the lining of the womb and mucus to make it resistant to Sperm. In some women ovulation (releasing of an egg) is prevented. This intrauterine system can be left in place for 5 years and many women find it very good as they have few periods or very light periods. The failure rate is extremely low. There are very few people who are not suitable for this method of contraception.

Intrauterine Device (coil)

An intrauterine device is commonly known as a coil. All coils now being inserted contain copper and they act by altering the lining of the womb and by being toxic to sperm. There may also be an effect on the mucus produced by the neck of the womb. Copper coils can be kept in place for 5-10 years depending on which one you have inserted. The failure rate is extremely low. Prior to having a copper coil inserted, you would be counselled fully about the benefits and side effects.

Depo-Provera Contraception

Depo-Provera is an injection of a hormone call progestogen. This prevents you ovulating (releasing an egg). The injection has to be given every 12 weeks and it is a very effective method of contraception. You would be counselled fully about the benefits and side effects of Depo-Provera prior to this being given. At any stage during the treatment, you could discontinue it. In some women, it can take a few months for periods to return to a regular pattern.    

Other Methods of Contraception

Combined Oral Contraceptive Pills (COC)

This method of contraception requires you to take a pill every day for 3 weeks and then have a week free. These pills contain two hormones Oestrogen and progestogen. The main method of action of these pills is to prevent you releasing an egg. If taken correctly the combined pill has a very low failure rate. Prior to being given a combined pill you would be assessed by a nurse or doctor, have your blood pressure checked, and a medical history taken, to check that you have no risk factors for complications with the pill. You would usually be seen 12 weeks later to check everything was alright and you can then continue on this method if it is suitable. There are certain conditions which make you unsuitable to have a combined pill and again these would be discussed with you in the clinic. The pill is a very effective method of contraception but you do need to remember to take it. Most pills are taken for 3 weeks and then there is a pill free week of 7 days and then you would start the pill again. This means that you have to be motivated and remember to take the pill as instructed. However, if you do miss a pill there is clear guidance on what you should do to prevent you becoming Pregnant.

Progestogen Only Oral Pill (POP)

This is a pill containing the hormone progestogen only. It is available in different preparations. This method of contraception is suitable for many women and it acts mainly by altering the cervical mucus (the mucus at the neck of the womb) making it more resistant to sperm. There is also an effect on ovulation (releasing an egg) in some cycles. There is a new progesterone only pill called Cerazette, which unlike other progesterone only pills does prevent release of an egg. This pill must be taken at the same time every day, however, it can be taken up to 12 hours late and still provide contraceptive cover. With all progesterone pills there is no pill free week.  This method would be discussed fully with you at the sexual health clinic.  If you had no problems in the first 3 months, the POP could be prescribed for 6 – 12 months depending on your health.

The Contraceptive Patch – EVRA

There is now a contraceptive patch containing hormones similar to the combined pill i.e. Oestrogen/Progesterone. This is only used in exceptional circumstances.