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Prescribing long-acting reversible contraception

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Women who require contraception should be given information about all methods and offered a full range of choices.1 This should include advice about long-acting reversible contraception (LARC).

LARC refers to methods of contraception that require administration less than once per cycle or month. These include the progestogen-only injectable Depo-Provera, the contraceptive implant Nexplanon and intrauterine methods such as the Mirena® coil.1

NICE advises that increasing the number of women who choose a LARC method may reduce the numbers of unintended pregnancies.1 However, the risk of STIs should be assessed when prescribing LARC. Verbal and written information should be provided to all women. Note that an update of the NICE guidance is expected towards the end of 2014.

LARC methods such as the progestogen-only implant and Depo-Provera are used less among women over 40 years than younger women. Women over 40 are more likely to use intrauterine methods.2

It is worth considering that LARCs are more cost-effective than the combined oral contraceptive pill at one year of use.

DMPA


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