RCGP statement on NICE LARC guidelines, UK

Main Category: Fertility
Article Date: 31 Oct 2005 - 0:00 PDT

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We welcome the publication of the NICE guidelines on long acting reversible contraception (LARC). This is an excellent opportunity to raise awareness of these methods among the professionals and the public. LARCs offer a real choice for women who wish to use reversible, reliable and effective contraception.

Some of these methods have suffered bad press due to myths and misconception which unfortunately have been perpetuated by some health care professionals. We should use this opportunity to dispel some of these myths. The intra-uterine device (IUD or "coil") and intra-uterine system (IUS or Mirena®) do not increase the risk of pelvic infection. The IUD/IUS can be fitted in young women, women who have never had children and those with a history of sexually transmitted infections or pelvic infections. Not all women suffer weight gain from using the contraceptive injections. No method of contraception causes infertility.

All LARCs have very good safety profiles and are suitable for the vast majority of women. Women who are unable to use estrogens (contained in the Pill) due to risk factors such as age, being overweight, smoking and migraine should consider one of the LARCs as a suitable alternative. Women over 40 can use the copper IUD until the menopause.

In the UK, less than 10% of women under 50 years use LARC as their contraception, compared with up to 20% in some Scandinavian countries. The UK has the highest rates of teenage pregnancies in Western Europe; increasing the use of LARCs can have a role in reducing the rates of unplanned pregnancies at any age.

Health care professionals need special training to fit IUDs, IUS and contraceptive implants. In order to facilitate access to LARCs, the challenge for many primary care organisations is to increase the number of doctors and nurses who are trained to fit them, and to ensure they have the opportunities to maintain their skills.

Other than condoms, no method of contraception offers protection from sexually transmitted infections. This is especially important for young people and those in new relationships, where the risk of acquiring infections such as Chlamydia is the greatest.

Dr Richard Ma
RCGP Sexual Health Spokesperson

Royal College of General Practitioners Press Office
14 Princes Gate
Hyde Park
London SW7 1PU
http://www.rcgp.org.uk

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