Extended Use of Long-Acting Reversible Contraception

Publication Date: June 15, 2022
Last Updated: November 30, 2023

Objective

Objective

This patient summary means to discuss key recommendations from the Society of Family Planning for extended use of long-acting reversible contraception.

Overview

Overview

  • Long-acting reversible contraception (LARC) includes intrauterine devices (IUDs) and the etonogestrel implant (under the skin). Both are highly effective methods of contraception (birth control).
  • We will use the abbreviation IUD throughout this summary to refer to intrauterine devices.
  • This patient summary focuses on the continued use of these devices beyond their FDA-approved duration.

Recommendations 

Recommendations 

Devices that are currently approved by the U.S. Food and Drug Administration (FDA) for 3-10 years, after which they are to be replaced:

Having trouble viewing table?
Content Brand Name FDA-approved duration (in years)
Copper 380 mm2 Paragard 10
Levonorgestrel* 52 mg IUD Mirena
Liletta		 7
6
Levonorgestrel* 19.5 mg IUD Kyleena 5
Levonorgestrel* 13.5 mg IUD Skyla 3
Etonogestrel* 68 mg subdermal implant Nexplanon 3
* Levonorgestrel and etonogestrel are hormones that prevent conception.
  • These contraceptives are effective beyond their FDA-approved duration.
    • The copper IUD has proved effective for 16 years in 8 women.
    • Effect up to 15 years has been shown for the higher dose devices.
    • Experience with lower doses is limited, but the effect of inert IUDs (without hormones) has been 98% for extended durations.
    • The etonogestrel implant appears to retain its effectiveness for 5 years.
  • Your weight does not affect the effectiveness of an IUD, although experience with very obese women is limited.
  • Menstrual bleeding is often diminished during extended use of any of the hormonal devices.
  • Extended use may increase the difficulty of removing your IUD.
  • Some other medicines may be affected by hormonal devices.
  • Your doctor will discuss risks and benefits and answer any questions you have before deciding on a contraceptive method that best suits you.

Abbreviations

  • FDA: Food And Drug Administration
  • IUD: Intrauterine Device
  • LARC: Long-acting Reversible Contraception

Source Citation

Dethier D, Qasba N, Kaneshiro B. Society of Family Planning clinical recommendation: Extended use of long-acting reversible contraception. Contraception. 2022 Jun 15:S0010-7824(22)00162-7. doi: 10.1016/j.contraception.2022.06.003. Epub ahead of print. PMID: 35716806.

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.