LARC. sample. ask brook about. Are any of them right for me? How effective is it? How long does it last? long acting reversible contraception

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72888_LARC:Layout 1 9/11/09 11:47 Page 1 Are any of them right for me? ask brook about LARC How effective is it? long acting reversible contraception How long does it last?

72888_LARC:Layout 1 9/11/09 11:47 Page 2 what is... long acting reversible contraception?

72888_LARC:Layout 1 9/11/09 11:47 Page 3 There are four types of long-acting reversible contraception (LARC). Long-acting means that the methods don t rely on you having to remember to take them. But they do require a professional to give them to you. They are all very effective. By reading this booklet, you ll have a better understanding of the different types of LARC, their advantages and disadvantages, and whether they re right for you...

72888_LARC:Layout 1 9/11/09 11:47 Page 4 Did you know? LARC methods are 99% effective in preventing pregnancy but do not protect from STIs.

72888_LARC:Layout 1 9/11/09 11:47 Page 5 First up... Sex can be a lot of fun, but it s even more fun when you re not worrying about unplanned pregnancy. Whether you re in a long term relationship or you ve just met someone new, it s always a good idea to talk about contraception and explore all the possibilities so that you re both in control as early as possible. Nobody wants to think about the risks of unprotected sex, but if you really want to relax and get the most out of sex, it s a good idea to give contraception some thought...

72888_LARC:Layout 1 9/11/09 11:47 Page 6 Definitions There are a number of words and phrases that we use in this booklet which might be helpful for us to explain upfront. Everyone has a different word for their genitals (some people call them private parts ) and it would be a pretty long booklet if we tried to put them all in. Throughout all our booklets, we use the standard terms penis, testicles and vagina. We also use the term anus for the opening in your bottom. Ovulation releasing an egg from the ovary Vaginal sex the penis entering the vagina Anal sex the penis entering the anus Oral sex licking, kissing or sucking the genitals Genital to genital contact any contact where genitals touch each other, with skin touching skin Straight sex sex between a man and a woman Gay sex sex between two people of the same sex

72888_LARC:Layout 1 9/11/09 11:47 Page 7 If you read anything in this booklet that doesn t make sense, or if you have any questions, do ask for advice from someone you trust you can always contact Ask Brook on 0808 802 1234.

72888_LARC:Layout 1 9/11/09 11:47 Page 8 How do the LARC methods work?

72888_LARC:Layout 1 9/11/09 11:47 Page 9 Contraceptive implant What is it? Implants are small, flexible rods (about 40mm long). A single implant is inserted under the skin of the upper arm to protect against becoming pregnant for up to three years. It releases the hormone progestogen. Advantages? It doesn t interrupt sex It works for up to three years Fertility returns immediately after the implant is removed Disadvantages? It doesn t protect against STIs It can make your periods irregular, heavier or stop them altogether It can temporarily cause headaches and skin problems Where can I get it from? Implants can only be inserted by qualified doctors and nurses. They re available free of charge at contraceptive clinics, young people s services, though your GP and at Brook Centres.

72888_LARC:Layout 1 9/11/09 11:47 Page 10 Contraceptive injections What are they? They are progestogen-based contraceptive injections that last for either eight weeks (Noristerat) or 12 weeks (Depo-Provera). The Depo-Provera injection is more commonly used in the UK. Advantages? It doesn t interrupt sex You don t have to remember to take a pill It may protect against cancer of the womb It may reduce heavy periods It can make period pain or pre-menstrual tension (PMT) less likely Disadvantages? It doesn t protect against STIs It can make your periods longer, irregular or stop them altogether It could lead to some weight gain

72888_LARC:Layout 1 9/11/09 11:47 Page 11 It can take a year or more for regular periods to return after you ve stopped using the injection Depo-Provera is a brand of injection that works by lowering levels of the female hormone estrogen and this can cause slight thinning of the bones by reducing bone mineral density Where can I get it from? Contraceptive injections are given only by a qualified doctor or nurse. They re available free of charge at contraceptive clinics, young people s services, through your GP and at Brook Centres.

72888_LARC:Layout 1 9/11/09 11:47 Page 12 Intrauterine system (IUS or the Mirena ) What is it? This is a small plastic T-shaped device that is fitted into the womb. It slowly releases progestogen to protect against pregnancy for up to five years. It may stop ovulation. Advantages? It doesn t interrupt sex It works for up to five years Your periods usually become lighter and less painful they may stop altogether after a year Your normal fertility returns after the IUS has been removed It s not affected by other medicines Disadvantages? It doesn t protect you against STIs If it fails, there s a small increased risk that a pregnancy will develop in the fallopian tube (known as an ectopic pregnancy) It may cause you to have temporary side effects like headaches, tender breasts or getting spots

72888_LARC:Layout 1 9/11/09 11:47 Page 13 Where can I get it from? The IUS can only be fitted by a trained doctor or nurse. It usually takes about 15-20 minutes and may hurt a bit although this shouldn t last for long and you may be given painkillers or a local anesthetic gel to help. You can go to a contraceptive clinic, young people s service, or a Brook Centre. They can also be fitted in some GPs, though not all. Once it is fitted you will need to go back for a check up three to six weeks later.

72888_LARC:Layout 1 9/11/09 11:47 Page 14 Intrauterine device (IUD or the coil ) What is it? The intrauterine device is a small device made from plastic and copper there are a range of different types available. When one is fitted in the uterus Sperm react to the copper, preventing them from reaching an egg. The IUD may also stop an egg settling in the womb. It is the only LARC method that doesn t have any hormones in it. What are the advantages? It doesn t interrupt sex It works straightaway It lasts for 5-10 years depending on the type of IUD fitted It can easily be removed by a professional

72888_LARC:Layout 1 9/11/09 11:47 Page 15 What are the disadvantages? It doesn t protect against STIs It can make your periods heavier, more painful or last longer If it fails, there is a risk that a pregnancy will develop in the fallopian tube (known as an ectopic pregnancy) but this is very rare Where can I get it from? The IUD can only be fitted by a trained doctor or nurse. It usually takes about 15-20 minutes and may hurt a bit although this shouldn t last for long and you may be given painkillers or a local anesthetic gel to help. You can go to a contraceptive clinic, young people s service, or a Brook Centre. They can also be fitted in some GPs, though not all.

72888_LARC:Layout 1 9/11/09 11:47 Page 16 Where can I find out more about LARC? You can find out more about LARC and discuss all your options at Brook Centres, contraceptive clinics, young people s services or at your local GP surgery (or you can go to a different GP if you prefer).

72888_LARC:Layout 1 9/11/09 11:47 Page 17 Why not go with your girlfriend / boyfriend? That way you ll both get the facts straight right from the start so talking about it afterwards will be a lot easier. Or maybe you d rather bring someone else a friend for a bit of support. That s fine too. Remember not all types of LARC are suitable for all people. Sometimes the doctor or nurse will ask a few questions about your medical and family history to help you decide which method is most suitable for you.

72888_LARC:Layout 1 9/11/09 11:47 Page 18 Where to get more help and advice... Now you ve read this booklet, if you have more questions, just Ask Brook. Ask Brook is for all young people under 25 anywhere in the UK. Did you know? Brook has a network of centres around the UK offering free and confidential sexual health advice and contraception to all young people under the age of 25. To find your nearest Brook Centre visit our website: www.brook.org.uk or contact the Ask Brook information service.

72888_LARC:Layout 1 9/11/09 11:47 Page 19 Ask Brook offers a confidential helpline, secure online enquiry service and text information service. Ask Brook is available free and in confidence to all young people on 0808 802 1234 or via Ask Brook on Brook s website, www.brook.org.uk The Ask Brook helpline is free from all telephones, including mobiles. Anyone under 25 can ask us anything about sexual health, including information, support and signposting about relationships, contraception, abortion, body worries around sexual health, STIs and sexuality. Tell us what s worrying you and we won t laugh, tut or tell. For information on key sexual health issues any time of day or night call our 24-hour information line 020 7950 7700. You will hear a recorded message and will then be asked to choose the topic you want more information on from a list of options. Other organisations you can contact are: fpa s helpline. Open from 9am until 6pm Monday to Friday on 0845 122 8690. Sexwise (for under 19s only). Open 7am to midnight every day on 0800 28 29 30. NHS Direct (for all ages). For medical advice 24 hours a day on 0845 46 47 (local call rate). Thank you to fpa for checking the clinical and factual accuracy of this booklet. October 2009

72888_LARC:Layout 1 9/11/09 11:47 Page 20 Designed by Andrassy Design 01484 434844 Registered charity number: 239966