Long-Acting Reversible Contraception (LARC): The FPA Guide
Helping you choose the method of ‘long-acting’ contraception that’s best for you
There are lots of different methods of contraception to choose from. You can choose a method that suits your preferences and lifestyle.
This guide has information about 3 very effective methods – the implant, copper IUD, and hormonal IUD. They work for 3 years or more and don’t depend on you remembering to take or use them.
This guide also has information about the contraceptive injection. This is usually given every 13 weeks. It’s not quite as effective as the other 3 methods but is very effective as long as you get every injection on time.
For more details see our guide to contraceptive injections.
Implant: Effectiveness
The implant is the most effective method of contraception.
It’s well over 99% effective. Fewer than 1 in 1,000 users will get pregnant in the first year of use. Once it’s fitted, it works for contraception for 3 years.
Implant: How it works
A small, flexible rod is put under the skin of your upper arm. It releases the hormone progestogen. It stops ovulation (releasing an egg), thickens cervical mucus to stop sperm reaching an egg, and thins the lining of the uterus (womb) to prevent a fertilised egg implanting.
Implant: How long it lasts
Works for 3 years but can be taken out sooner if you choose
Implant: How it affects periods
Your bleeding is likely to be unpredictable. Your periods may stop or you might have very little bleeding, or bleeding might be irregular or last longer.
Implant: How it affects fertility
Your fertility returns to normal as soon as the implant is removed.
Implant: How it’s inserted and removed
A doctor or nurse uses a local anaesthetic to numb the skin on the inner side of your upper arm and then inserts the implant. It takes a few minutes and feels like having an injection.
To remove it, the doctor or nurse uses a local anaesthetic, makes a small cut and gently pulls the implant out.
For more details see our guide to contraceptive implants.
Copper Coil: Effectiveness
The copper intrauterine device (IUD) is over 99% effective. Fewer than 1 in 100 copper IUD users will get pregnant in a year.
Once it’s fitted, it works for contraception for 5 or 10 years, depending on the type.
Copper Coil: How it works
A small, flexible plastic and copper device is put into the uterus (womb). The copper stops sperm and eggs from surviving. It also changes your cervical mucus to stop sperm from reaching an egg. The copper IUD may also stop a fertilised egg implanting in the uterus.
Copper Coil: How long it lasts
Works for 5 or 10 years, depending on type, but can be taken out sooner if you choose. If fitted at or after age 40, it can stay in place until after the menopause when contraception is no longer needed.
Copper Coil: How it affects periods
Your periods may be heavier, longer or more painful. This may reduce over time. You may get bleeding between periods.
Copper Coil: How it affects fertility
Your fertility returns to normal as soon as the copper IUD is taken out.
Copper Coil: How it’s inserted and removed
A doctor or nurse will insert the copper IUD. Your appointment will last around 20 to 30 minutes. Inserting the IUD usually takes around 5 minutes. It can be uncomfortable or painful for some people and you may be offered a local anaesthetic.
The copper IUD has threads which hang through the cervix (opening of the uterus) into the top of your vagina. A doctor or nurse can remove the IUD by pulling gently on the threads.
For more details see our guide to the Copper IUD (copper coil).
Hormonal IUD: Effectiveness
The hormonal intrauterine device (IUD) is over 99% effective. Fewer than 1 in 100 hormonal IUD users will get pregnant in a year.
Once it’s fitted, it works for contraception for 3, 5 or 8 years, depending on the type.
The hormonal IUD is sometimes called the intrauterine system (IUS).
Hormonal IUD: How it works
A small, flexible T-shaped plastic device is put into the uterus (womb). It releases the hormone progestogen. This thickens cervical mucus to stop sperm reaching an egg and thins the lining of the uterus to stop a fertilised egg implanting.
Hormonal IUD: How long it lasts
Works for 3, 5 or 8 years, depending on type, but can be taken out sooner if you choose.
If fitted at or after age 45, a Mirena, Levosert or Benilexa IUD can stay in place as contraception until age 55, or after the menopause, when contraception is no longer needed.
Hormonal IUD: How it affects periods
It’s common for bleeding to change. It usually becomes lighter, shorter, less frequent and less painful, and may stop altogether. In the first few months, it may be unpredictable, more frequent, or last longer.
Hormonal IUD: How it affects fertility
Your fertility returns to normal as soon as the hormonal IUD is taken out.
Hormonal IUD: How it’s inserted and removed
A doctor or nurse will insert the hormonal IUD. Your appointment will last around 20 to 30 minutes. Inserting the IUD usually takes around 5 minutes. It can be uncomfortable or painful for some people and you may be offered a local anaesthetic.
The IUD has threads which hang through the cervix (opening of the uterus) into the top of your vagina. A doctor or nurse can remove the IUD by pulling gently on the threads.
For more details see our guide to the Hormonal IUD (Hormonal coil, was IUS).
Injection: Effectiveness
With perfect use, over 99% effective. Fewer than 1 in 100 injection users will get pregnant in a year. Perfect use means that you always use the injection exactly as instructed and get the injection on time every 13 weeks.
With typical use, around 94% effective. Around 6 in 100 injection users will get pregnant in a year. Typical use means that you don’t always use the injection as instructed, for example, if you have an injection late.
Injection: How it works
It releases the hormone progestogen. This stops ovulation (releasing an egg), thickens cervical mucus to stop sperm reaching an egg, and thins the lining of the uterus (womb) to stop a fertilised egg implanting.
The injection can’t be removed from the body so any side effects may continue for as long as it works and for some time afterwards.
Injection: How long it lasts
Must be given every 13 weeks (Depo-Provera and Sayana Press) or every 8 weeks (Noristerat). Noristerat isn’t commonly used in the UK.
Injection: How it affects periods
Your periods may stop, or bleeding may be irregular or longer.
Injection: How it affects fertility
Your periods and fertility may take up to 1 year to return after stopping the injection. It may take more time for some people and less time for others.
Injection: How it’s inserted and removed
Depo-Provera is injected into a muscle, usually in your buttocks. It can sometimes be given in your arm.
Sayana Press is injected beneath the skin at the front of your thigh or abdomen with a tiny needle. It’s possible for you to be taught how to inject Sayana Press yourself at home. Ask your clinic or GP surgery about this.
For more details see our guide to Contraceptive Injections.
You can get free contraception, including emergency contraception, from:
- most GP surgeries
- a contraception clinic or sexual health clinic
- a young people’s service (these have an upper age limit)
- some online services.
You can also get free emergency contraceptive pills from some pharmacies and some genitourinary medicine (GUM) clinics.
The Sexual Health Helpline gives confidential advice and information on sexual health - including contraception.
The number is 0300 123 7123. It's open Monday to Friday from 9am to 8pm and at weekends from 11am to 4pm.
You can also find our full range of Family Planning Association's patient information guides here.
Find details of sexual health clinics and services, GP surgeries and pharmacies on these websites:
- England: www.nhs.uk
- Northern Ireland: www.sexualhealthni.info and nidirect.gov.uk
- Scotland: www.nhsinform.scot
- Wales: 111.wales.nhs.uk
If you've had sex without contraception, or think your method might have failed, you can use emergency contraception.
Try to get emergency contraception as soon as possible after unprotected sex to give it the best chance of working.
A copper intrauterine device (IUD) is the most effective option. Some people will get pregnant even when they take emergency pills correctly.
- An emergency IUD (copper coil) can be fitted up to 5 days after sex, or up to 5 days after the earliest time you could have ovulated (released an egg).
- An emergency contraceptive pill with the active ingredient ulipristal acetate (UPA) can be taken up to 5 days (120 hours) after sex.
- An emergency contraceptive pill with the hormone levonorgestrel can be taken up to 3 days (72 hours) after sex.
Emergency pills are available for free with a prescription or to buy from a pharmacy.
For more details see our guide to Emergency Contraception here.
Most methods of contraception don't protect you from sexually transmitted infections (STIs).
Condoms and internal condoms (also known as female condoms), used correctly and consistently, can help protect against STIs.
Try to avoid using condoms that are lubricated with spermicide. Most spermicides have a chemical called nonoxinol-9, which may irritate the skin and increase the risk of HIV and other infections. Regular lubricated condoms are fine.
For more details see our sexually transmitted infection guides here.
This guide can only give you general information. The information is based on evidence-guided research from The Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists, the National Institute for Health and Care Excellence, and the World Health Organization.
All methods of contraception come with a detailed patient information guide.
Contact your healthcare professional or a sexual health clinic if you are worried or unsure about anything.
This guide was accurate at the time of writing. Guides are reviewed regularly.
Last complete review: May 2023, last clinical update: January 2024, next review scheduled: September 2024.
If you’d like information on the evidence used to produce this guide or would like to give feedback, email fpadirect@fpa.org.uk.
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