Designed and created by Guideline Central in participation with the Society of Family Planning
Extended Use of Long-Acting Reversible Contraception
Publication Date: June 15, 2022
Last Updated: November 30, 2023
This patient summary means to discuss key recommendations from the Society of Family Planning for extended use of long-acting reversible contraception.
- 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.
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:
|Content||Brand Name||FDA-approved duration (in years)|
|Copper 380 mm2||Paragard||10|
|Levonorgestrel* 52 mg IUD||Mirena |
|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.
- FDA: Food And Drug Administration
- IUD: Intrauterine Device
- LARC: Long-acting Reversible Contraception
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.
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.