Long Acting Reversible Contraception (LARC)

The data below are taken from the following source:  

• Long Acting Reversible Methods of Contraception in Scotland, year ending 31 March 2021. They are based on NHS prescription data from General Practices and specialist community based sexual health and family planning clinics (collected via the National Sexual Health System - NaSH). 

Data on three forms of long acting reversible contraception (LARC) are reported here: 

• the contraceptive implant, a small progesterone-only rod inserted into the arm (under the skin). It can provide protection from pregnancy for up to three years. 

• the intrauterine device (IUD) (sometimes called a coil), which is inserted into the womb and can provide protection from pregnancy for up to 10 years (sometimes longer). 
• the intrauterine system (IUS), which is inserted into the womb like an IUD, but also contains synthetic progesterone which is gradually released into the womb to prevent pregnancy. Two IUSs are used by NHS Scotland, Mirena (which lasts for up to five years) and Jaydess (lasts for up to three years).  

 Further information about contraception methods is available from the NHS Choices website. 

Data limitations 

The data on LARC prescribing relate to new insertions of devices in a given year, no data are collected on subsequent removals. This means that the figures presented here do not provide an estimate of the proportion of women using a LARC method at a particular point in time. Also note that the IUS is not solely used for contraception, it can also be used to help manage heavy periods. 

This report focuses on very long acting methods of contraception; namely the contraceptive implant, IUD and IUS. Contraceptive injections are also reported on but are presented separately. As multiple contraceptive injections are required per year it is difficult with the current information to determine person level data. As such, while rates are shown to allow comparison between NHS Board areas, caution should be taken interpreting these rates.  

Comparisons in insertion rates between Boards are affected by the fact that some people access sexual health services in Boards other than where they live. Therefore, only national-level figures are reported here. 

Insertion rates 

The latest report shows that rates of prescribing of LARC have been significantly impacted by the COVID-19 pandemic across all NHS board areas, decreasing from 54.3 per 1,000 women in 2019/20 to 32.1 per 1,000 women in 2020/21. Amongst the mainland NHS Boards, NHS Dumfries and Galloway had the highest rate of prescribing of LARC with 46 per 1,000 women, while NHS Lanarkshire had the lowest with 10.3 per 1,000 women. The contraceptive implant remains the most commonly prescribed LARC method, with rates of 15.8 per 1,000 women, followed by the intrauterine system (IUS), with 11.9 per 1,000 women and the intrauterine device (IUD), with rates of 4.3 per 1,000 women.

Note that data prior to 2013/14 was collected from settings no longer included in the figures reported here. In addition, some of the figures for LARC use previously reported for this earlier period included prescriptions that had not been dispensed. Therefore, the estimates presented here cannot be compared with earlier estimates, and it is unclear whether LARC prescribing in the 2013/14-2017/18 period is higher than it was previously.