Long-Acting Reversible Contraception

Baker, Courtney C. MD, MPH; Creinin, Mitchell D. MD

Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, California.

Corresponding author: Mitchell D. Creinin, MD, University of California, Davis, Sacramento, CA; email:[email protected].

Financial Disclosure Mitchell D. Creinin has received speaking honoraria from Gedeon Richter and Mayne, serves on an Advisory Boards for Evofem, Fuji Pharma, Mayne, Merck, Searchlight, and TherapeuticsMD, and is a consultant for Estetra SRL, Libbs, Mayne, and Medicines360. The Department of Obstetrics and Gynecology, University of California, Davis, receives contraceptive research funding for Dr. Creinin from Chemo Research SL, Evofem, HRA Pharma, Medicines360, Merck, and Sebela. Courtney Baker did not report any potential conflicts of interest.

This article discusses Liletta, which is scheduled for approval for 8-year use by the U.S. Food and Drug Administration in November 2022.

Each author has confirmed compliance with the journal's requirements for authorship.

Peer reviews and author correspondence are available athttps://links.lww.com/AOG/C892.

Obstetrics & Gynecology140(5):p 883-897, November 2022. |DOI:10.1097/AOG.0000000000004967

Long-acting reversible contraceptive (LARC) methods are effective options for pregnancy prevention. Currently available products in the United States include an etonogestrel implant, a copper intrauterine device (IUD), and several levonorgestrel IUDs. With increasing prevalence and duration of use, our understanding of efficacy, risks, and benefits has evolved. In addition to a brief discussion on nomenclature and LARC use within a framework of bodily autonomy and reproductive justice, this review covers clinical challenges with placement and removal, evidence-based duration of use, and how to mitigate side effects. Although all obstetrician–gynecologists as well as primary care clinicians can safely provide LARCs, complex family planning specialists are an expert referral source for challenging cases and evidence-based care as contraceptive technology continues to develop.