Long-acting reversible contraceptives

Long-acting reversible contraceptives (LARC) are methods of birth control that provide effective contraception for an extended period without requiring user action. They include hormonal and non-hormonal intrauterine devices (IUDs) and subdermal hormonal contraceptive implants. They are the most effective reversible methods of contraception because their efficacy is not reliant on patient compliance. The failure rates of IUDs and implants is less than 1% per year.

LARCs are often recommended to people seeking convenient and cost effective contraception. In one study, LARC users saved thousands of dollars over a five-year period compared to those who buy condoms and birth control pills. LARCs can generally be safely and effectively used by people of any body weight, adolescents, and people who have not yet had children.

In 2008, the American College of Obstetrics and Gynecologists (ACOG) launched The Long-Acting Reversible Contraception Program with the intention to reduce rates of unintended pregnancy by promoting LARCs, often referred to as a "LARC-first" model. Rates of LARC use in the United States rose steadily in that time frame, from 3.7% in 2007 to 10% in 2019. LARC methods are most popular amongst people in their late teens and early twenties. LARC use varies globally, with different regions reporting different use rates. An estimated 161 million people of reproductive age use an IUD and an additional 25 million use an implant; this is 19.4% of the estimated global population of women of reproductive age.

LARC methods include IUDs and the subdermal implant.

IUDs, also sometimes referred to as IUS (intrauterine system) or IUC (intrauterine contraception), can come in hormonal or nonhormonal varieties.

LARCs have higher rates of efficacy than do other forms of contraception. This difference is likely due to the difference between "perfect use" and "typical use". Perfect use indicates complete adherence to medication schedules and guidelines. Typical use describes effectiveness in real-world conditions, where patients may not fully adhere to medication regimens. LARC methods require little to no user action after insertion; therefore, LARC perfect use failure rates are the same as their typical use failure rates. LARC failure rates are comparable to those of sterilization. LARCs and sterilization differ in their reversibility.

The implant has a 0.05% failure rate in the first year of use, the levonorgestrel (hormonal) IUD has a 0.1% failure rate in the first year of use, and the copper IUD has a 0.8% failure rate in first year of use. These rates are comparable to those of permanent sterilization procedures, leading to conclusions that LARCs should be offered as "first-line contraception."

LARCs can also be used to treat other conditions, primarily by regulating or stopping the bleeding portion of a user's menstrual cycle. LARCs may be used to treat endometriosis and heavy menstrual bleeding. They can also be useful in treating painful menstruation.