Advice about duration of use for users having implants and intrauterine contraception inserted at the current time.
Date: 03 Jun 2021
Type: FSRH Clinical Guidance and Clinical Statements
The FSRH CEU has recommended extended use of some long-acting reversible contraceptives.
During the COVID-19 pandemic, FSRH CEU has recommended extended use of some long-acting reversible contraceptives.
The benefit of avoiding risk of COVID transmission during replacement of a recently-expired etonogestrel implant, 52mg LNG-IUS or 10-year copper IUD was considered to outweigh the small risk of pregnancy during one year of extended use of these LARC devices (2 years of extended use for the 10 year copper IUD). Users could choose to use additional contraceptive precautions, as although evidence suggests that the risk of pregnancy during such extended use is low we do not know for certain whether contraception is as effective as it is during licensed use.
This recommended extension of use of long-acting reversible contraceptive (LARC) methods does not apply at times when COVID-19 transmission risk is not a significant consideration. We hope that this will be the situation by the time LARC devices currently being inserted are due for replacement.
So what should I advise someone who is having LARC inserted now?
If you are inserting a long-acting reversible contraceptive at the current time, you should advise the user that it should be replaced at the end of the licensed duration of use - except in the case of copper IUDs inserted after age 40 years and 52mg LNG-IUS devices inserted after age 45 years, which (in line with pre-COVID guidance) can be used for contraception until age 55 years.