Long-acting reversible contraceptives
LARCs
Peer reviewed by Dr Colin Tidy, MRCGPLast updated by Dr Rosalyn Adleman, MRCGPLast updated 10 Feb 2023
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In this series:Contraceptive implantContraceptive injectionIntrauterine contraceptive deviceLevonorgestrel intrauterine device
Long-acting reversible contraceptives are very effective birth control methods. When you use one of these, you do not have to rely on remembering something every day. They last between 2 months and 10 years, depending on the option used. They may come in the form of injections, implants, and also devices which are placed in your womb (uterus).
At a glance
Long-acting reversible contraception (LARC) is a type of birth control.
There are four types of LARC: the implant, the injection, the IUCD, and the IUS.
Once fitted, LARCs can last for three, five, or ten years, depending on the type.
LARCs are very reliable because you do not need to remember to take them daily.
They are reversible, so you can become fertile again after removal.
In this article:
Video picks for Long-acting reversible contraceptives
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What are the long-acting reversible contraceptive choices?
There are four types of long-acting reversible contraception (LARC).
The contraceptive implant. A minor procedure under local anaesthetic is needed to insert the small, rod-shaped implant under the skin in your upper arm, where it remains. The implant releases a progestogen hormone. Each implant lasts three years. Read about the contraceptive implant.
The contraceptive injection. An injection of a progestogen hormone is given every three months (two months for one brand), most commonly into the muscle in your bottom. Read about the contraceptive injection.
The intrauterine contraceptive device (IUCD). This is also known as 'the coil'. It sits inside the womb (uterus) and, once fitted, can stay in your womb for up to ten years. The device is called a coil because in the 1960s some devices were coil-shaped. Read about the intrauterine contraceptive device.
The intrauterine system (IUS). This is a specific type of IUCD which releases a progestogen hormone into the womb. It can last for up to five years. Read about the intrauterine system (IUS).
Why would I choose long-acting reversible contraception?
Back to contentsLARCs are ideal for women who do not want a baby in the near future. This might be because you think you have completed your family and don't want more children, but want to keep your options open. Or it might be because you are young and not wishing to have children for some years to come. Or because you don't want children at all. Or because you are not currently in a position to have children, because of your job, relationship or finances. The great thing about LARCs is the word "reversible" - so if your situation changes, you can stop using them and become fertile again.
You don't need to take a tablet every day, so for most LARCs, you can forget about contraception for years at a time. This makes them more reliable (as they don't need you to remember, other than when they are due to be replaced).
The main downside is that they all require a small procedure of some sort. However, this does not have to be done very often, and provides long-term, reliable contraception once you have done it.
Continue reading below
Which LARC should I choose?
Back to contentsThis is an individual choice. Different people will prefer different options. Pros and cons of each are weighed up in the separate leaflet called Contraception Methods, and there is plenty of information about each in their individual leaflets as linked above.
Patient picks for Long-acting reversible contraceptives

Sexual health
Levonorgestrel intrauterine device
The levonorgestrel intrauterine device (LNG-IUD), previously known as the intrauterine system (IUS) is a small, flexible, plastic device which sits inside the womb (uterus). There are two threads attached to it which pass out through the neck of the womb.
by Dr Toni Hazell, MRCGP

Sexual health
Contraceptive injection
The contraceptive injection contains a progestogen hormone. It is used to prevent pregnancy.
by Dr Caroline Wiggins, MRCGP
Frequently asked questions
What makes LARCs more effective than methods like the pill?
LARCs are considered very reliable because, unlike daily pills, they don't require you to remember to do anything regularly. Once placed, they work continuously for years, which reduces the chance of human error affecting their effectiveness.
How often do I need to visit a doctor for LARC once it's fitted?
After the initial procedure to insert a LARC, you generally don't need frequent doctor visits for contraception. Depending on the type, you can forget about it for anywhere from three to ten years until it needs to be replaced.
Are all LARCs hormone-based?
Most LARCs release a progestogen hormone, such as the implant, injection, and the intrauterine system (IUS). However, there is also the intrauterine contraceptive device (IUCD), also known as 'the coil', which does not release hormones.
If I decide to have children earlier than planned, can I have my LARC removed at any time?
Yes, the term "reversible" in LARC means that if your situation changes and you wish to become pregnant, you can have the device removed. Once it's removed, you can become fertile again.
Is it painful to have a LARC fitted or removed?
The article mentions that inserting the contraceptive implant is a "minor procedure under local anaesthetic." For other LARCs, it states that they "require a small procedure of some sort." The article does not elaborate further on the pain experienced during fitting or removal for any of the devices.
Further reading and references
- Long-acting reversible contraception; NICE Clinical Guideline (October 2005 - updated July 2019)
- Trussell J; Contraceptive failure in the United States, Contraception, 2011
- Intrauterine Contraception; Faculty of Sexual and Reproductive Healthcare Clinical Effectiveness Unit (March 2023 - last updated July 2023)
- UK Medical Eligibility Criteria Summary Table for intrauterine and hormonal contraception; Faculty of Sexual and Reproductive Healthcare, 2016 - amended September 2019
- Contraception - Progestogen-only methods; NICE CKS, September 2022 (UK access only)
Continue reading below
About the authorView full bio

Dr Mary Harding, MRCGP
General Practitioner, Medical Author
BA, MA, MB, BChir, MRCGP, DFFP
Dr Mary Harding qualified from Cambridge University medical school in 1989.
About the reviewerView full bio

Dr Colin Tidy, MRCGP
General Practitioner, Medical Author
MBBS, MRCGP, MRCP (Paediatrics), DCH
Dr Colin Tidy is an NHS Doctor, based in Oxfordshire.
Article history
The information on this page is written and peer reviewed by qualified clinicians.
Next review due: 9 Feb 2028
10 Feb 2023 | Latest version
30 Oct 2017 | Originally published
Authored by:
Dr Mary Harding, MRCGP

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