What is LARC?
“LARC” stands for long-acting reversible contraception
Two types of LARC methods available in the United States:
- Intrauterine devices (IUDs)
- Contraceptive implant
Two advantages of LARC include:
- LARC does not require ongoing effort for long-term and effective use
- Rapid return to fertility after removal of the device
Disadvantage of LARC includes:
- LARC must be placed and removed by a trained clinician, which may impact patient autonomy

Types of LARC

Contraceptive implant
(about the size of a match stick)

Intrauterine device (IUD)
(about the size of a quarter)
Levonorgestrel (LNG) IUD
Mechanism of Action:
- Prevent fertilization by changing amount and viscosity of cervical mucus, making it impenetrable to sperm
Evidence supports that LNG IUDs do not disrupt pregnancy and are not abortifacients
Most women ovulate normally, but experience diminished menstrual bleeding because of the local effect of levonorgestrel on the endometrium
99.8% effective; the one-year typical use failure rate is 0.2 per 100 women

Copper IUD
Mechanism of Action:
- Inhibition of sperm migration
- Change in transport speed of ovum
- Damage to or destruction of the ovum
Evidence supports that the copper IUD does not disrupt pregnancy and is not an abortifacient
The most common adverse effects reported are abnormal bleeding and pain
99.2% effective; the one-year typical use failure rate is 0.8 per 100 women

Etonogestrel (ENG) implant
Mechanism of Action:
- Primary: ovulation suppression
- Additional: thickening of cervical mucus and alteration of the endometrial lining
After implant insertion, changes in bleeding patterns are common and include amenorrhea or infrequent, frequent, or prolonged bleeding
Placed subdermally in upper arm; size: 4cm x 2mm (comparable in size to a match stick)
99.9% effective; the one-year typical use failure rate is 0.05 per 100 women

Current LARC Methods
Description | Brand Name of Method | Type of Method | FDA-Approved Duration of Use |
---|---|---|---|
Hormonal IUD | Kyleena® | 19.5 mg LNG IUD | 5 years |
Liletta® | 52 mg LNG IUD | 6 years | |
Mirena® | 52 mg LNG IUD | 6 years | |
Skyla® | 13.5 mg LNG IUD | 3 years | |
Copper IUD | Paragard® | Copper IUD | 10 years |
Contraceptive Implant | Nexplanon® | 68 mg ENG implant | 3 years |