Introduction:
Due to the advancements and innovations in contraceptives, there is wide fame associated with the use of long-acting contraceptives, which are well acknowledged and well tolerated by patients. However, according to the World Health Organization (WHO), contraceptives are classified as high efficacy, moderate efficacy, and least efficacy.
However, long-acting reversible contraceptives like implants or intrauterine devices are highly effective, can be sterilizable, and can be used for over three years. Long-acting contraceptives evolved to foster women's empowerment and health. This medication was also developed because of numerous studies that were conducted to understand the preferences and effectiveness of the contraceptive, its types, fertility rates, and the type available in the market.
What Are Long-Acting Contraceptives?
Long-acting reversible contraceptives (LARC) are birth control treatments that help prevent the chances of pregnancy for a long time. They are considered to be the most efficient reversible birth control options, and these services include intrauterine devices and contraceptives. These intrauterine devices or long-acting reversible contraceptives are considered easily reversible and safe. The LARC treatment helps prevent pregnancy for a minimum of three to ten years, varying from one manufacturer to the other.
What Are the Types of Long-Acting Contraceptives?
There are various types of long-acting contraceptive devices available in the market, and they are:
Contraceptive Implants:
These are rod-like structures placed within the subcuticular tissue of the inner upper arm. This method causes atrophy of the endometrial cells, thus preventing pregnancy.
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Advantages: The advantage of this method is that it is a highly effective contraceptive and easy to use.
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Disadvantages: This method is contraindicated in pregnancy, with idiopathic abnormal vaginal bleeding, breast cancer, metal allergies, and active liver diseases.
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Side Effects: The side effects include weight gain, headaches, and mood swings.
Levonorgestrel Releasing Intrauterine System:
This is a T-shaped frame made of polythene where a drug called Levonorgestrel is released. But this technique has a 0.2 percent of failure rate in the first year of usage. This contraceptive creates a thick cervical mucus which inhibits the penetration and motility of the sperm, which in turn causes endometrial atrophy, thus suppressing ovulation.
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Advantages: This contraceptive method's advantages are its high potency and ease of use.
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Disadvantages: The method is not advisable in patients with systemic conditions and women who cannot use estrogen-containing contraceptives.
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Side Effects: The side effects of using long-acting contraceptives are pregnancy, pelvic inflammation, positive signs for gonorrhea, sepsis post-abortion, liver diseases, genital tract cancers, allergies occurring due to copper or any agent in the long-acting contraceptive, and breast cancers. The physical complications include perforation of the uterine wall and amenorrhea (a clinical condition characterized by lack of menstruation) whose management can be expensive for the patient to afford.
Copper T380 Intrauterine Device (IUD):
This is a T-shaped copper frame wrapped within the two arms of the fallopian tube. This method is very effective and can last up to ten years, and the copper T has a minimal failure rate of 0.6 to 0.8 percent in the first year, as copper tends to decrease the ability of the sperm to fertilize the ovum.
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Advantages: It can be used in both parous and nulliparous women and is also convenient for adolescents and young women.
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Disadvantages: This is contraindicated in cases of breast cancers and liver diseases.
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Side Effects: The side effects of using this are amenorrhea, bleeding between periods, cramps, pain in the pelvis, heavy vaginal bleeding, and infection.
What Are the Effects of Long-Acting Contraceptives on Women?
Women empowerment is the concept that enables women to acquire resources like education, enhancing women's position in the community and giving them their right to choose life and health choices. As a result, and due to persistent gender inequality, women's empowerment and promotion of contraceptives came into existence. Although there are several contraceptive methods, like short-acting and long-acting, the long-acting reversible contraceptives or the LARC method show a significant decline in fertility rates. The usage of the LARC is also predominantly seen as the choice of contraception in women making combined decisions with their partners. Therefore, many observational studies were performed to study and compare the effect of short and long-acting contraceptives.
It was observed that the women who chose long-acting contraceptives differed in lifestyle compared to those who chose short-acting contraceptives. Also, long-acting contraceptives are widely accepted, whereas there is no complete scientific acceptance or evidence of success in the long-term use of short-acting contraceptives. According to the studies, there was a steady increase in the use of LARC from 1984 to 2000 and then a shift in the preference for short-acting contraceptives like tablets compared to long-acting ones.
Furthermore, after almost one year of the long-acting reversible contraceptives, women in the randomized trials had high continuation rates, consequently experiencing superior protection from unplanned pregnancy compared to the shorter-acting ones, where these benefits push the women to take up long-acting contraceptives in a broader population scale voluntarily.
What Are the Reasons To Use Long-Acting Contraceptives?
Possible reasons for women of reproductive age to choose this method of contraception are:
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They have a longer protection period.
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Spacing between two children.
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Highly potent contraceptive when compared to the others.
What Are the Reasons for Not Opting for Long-Acting Contraceptives?
Most women commonly opt for shorter-acting drugs due to the following reasons, and they are:
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Lesser in cost.
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Easy to use and gives privacy to the patient.
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Fewer side effects.
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Possible convenience in planning the family as desired.
These points can also be a key drawback in using long-acting contraceptives.
Conclusion:
Although long-acting reversible contraceptives are reversible and have high efficacy, contraceptives themselves come with many side effects when used. This is because contraceptive devices were used to control fertility and birth rates, maintain women's health, give proper healing after childbirth, and decrease the mortality rate during pregnancy. But on the contrary, it should also be kept in mind that any external agent can cause possible side effects like bleeding or altered hormonal levels. So long-acting reversible contraceptives are considered a boon when used at the correct period and under the correct guidance.
