Long-acting reversible contraception covers the implant, hormonal and copper intrauterine devices, and the contraceptive injection. They are highly effective largely because they remove the need to remember anything.
The word reversible does real work here, and it varies between them. An implant or coil can be removed at any time and fertility returns quickly. An injection cannot be undone once given, lasts until it wears off, and fertility may take longer to return. If that difference matters to you, it should shape the choice.
Common hormonal medicine side effects
All the hormonal options share a similar list: changes to bleeding, headaches, breast tenderness, acne, mood changes and altered libido. Because they contain no oestrogen, they can generally be used by people who cannot take combined pills, and they do not carry the same clot risk.
The copper coil is the exception: it contains no hormone at all, so it causes none of the hormonal effects. Its trade-off is that periods often become heavier and more painful, particularly at first.
Bleeding, mood, skin, weight and cycle changes
Bleeding is the main difference between them, and the main reason people stop:
- Hormonal coil. Irregular bleeding for the first three to six months, then usually much lighter periods, often stopping. Also used to treat heavy periods. See Mirena.
- Implant. Unpredictable, and the early pattern tends to be the pattern that persists. Some have no bleeding, some regular, some prolonged. See contraceptive implant side effects.
- Injection. Irregular at first, then periods often stop altogether with continued use. See contraceptive injection side effects.
- Copper coil. Periods usually continue and may be heavier.
Weight gain is reported most consistently with the injection. Bone density is a consideration with prolonged injection use, which is why long-term use is reviewed periodically.
Serious warning signs that need medical attention
Contact your clinic urgently for: severe pelvic pain, fever or unusual discharge, particularly in the weeks after a coil is fitted; a missed period with abdominal pain; being unable to feel your coil threads or your implant; signs of infection at an implant or injection site; or very heavy bleeding causing dizziness.
Who may be at higher risk?
Tell your clinician about current or recent pelvic infection, unexplained vaginal bleeding, known abnormalities of the womb, liver conditions, a history of breast cancer, risk factors for bone thinning, or plans to conceive within the next year.
Some epilepsy medicines, rifampicin and St John’s Wort can reduce the effectiveness of the implant. Coils are not affected in the same way, which sometimes makes them the better option.
None of these protect against sexually transmitted infections.
What to discuss with your doctor, pharmacist or clinic
- Which of these fits what I want from my periods?
- How quickly can it be removed or reversed if I do not get on with it?
- How soon does fertility return afterwards?
- What does insertion involve, and what should I expect afterwards?
- When is it due for replacement?
- Do any of my medicines reduce how well it works?
Related contraception, HRT and hormonal medicine guides
- Hormonal contraception side effects
- Birth control side effects
- Women’s health and hormonal medicine side effects
- When to see a doctor about hormonal medicine
- Report a hormonal medicine side effect
See also Implanon, Nexplanon and long-term injection side effects.
Medical Disclaimer: This content is for informational and educational purposes only and does not constitute medical diagnosis, prescription, or professional advice. Always read the patient information leaflet and consult a qualified doctor or pharmacist regarding any medicine or health concern.