Advantages and Disadvantages of Long‑Acting Reversible Contraceptives (LARC): An Evidence‑Based Review

Abstract

Long‑acting reversible contraceptives (LARCs)—including copper intrauterine devices (IUDs), levonorgestrel‑releasing IUDs, and the etonogestrel implant—are the most effective reversible methods of contraception. This narrative review synthesizes clinical efficacy and safety data together with evidence on awareness and misconceptions, with emphasis on adolescents and young adults. LARCs offer top‑tier effectiveness (<1% typical‑use failure), high continuation and satisfaction, rapid return to fertility, and important non‑contraceptive benefits (e.g., treatment of heavy menstrual bleeding). Disadvantages include insertion requirements, bleeding changes, rare complications (expulsion and perforation), and persistent knowledge gaps that limit uptake. Evidence‑informed counseling, trained providers, and removal of cost barriers are key to maximizing benefits while minimizing harms.