How can I effectively counsel patients on contraception options, including long-acting reversible contraceptives?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 14 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

To effectively counsel patients on contraception options, including long-acting reversible contraceptives (LARC), it is essential to ensure patient involvement and informed decision-making .

  • Provide Comprehensive Information: Offer information on all contraceptive methods, including LARC, to enable an informed choice ,. This information should be both verbal and written, tailored to the individual's needs, and presented in easily understandable language and formats ,. Key details to cover include:
    • Contraceptive efficacy ,.
    • Duration of use .
    • How each method works .
    • Risks and possible side effects ,.
    • Non-contraceptive benefits .
    • The procedure for initiation and removal or discontinuation .
    • When to seek help while using the method .
    • Possible drug interactions .
    • Health risks and benefits of the methods .
    • Information on return to fertility after discontinuing the methods .
  • Conduct a Thorough Assessment: Before initiating any contraceptive method, a medical history should be taken, including relevant family, menstrual, contraceptive, and sexual history ,. Pregnancy must be excluded ,. Assess the patient's suitability for different methods by identifying factors such as comorbidities, allergies, lifestyle, reproductive history, drug treatments, and age . Utilise nationally agreed guidance like the UK Medical Eligibility Criteria (UKMEC) to ensure safe use of methods ,.
  • Ensure Sensitivity and Accessibility: Counselling should be sensitive to cultural differences and religious beliefs . For patients who are not English speaking, or have sensory impairments or learning disabilities, ensure access to trained interpreters or advocates .
  • Address Special Considerations:
    • Young People: Be aware of the law regarding advice and contraception for young people, considering child protection issues and Fraser guidelines for those under 16 years ,. All methods can be considered, but avoid regular hormonal contraception in sexually active girls who have not started menstruating .
    • Patients on Teratogenic Drugs: Advise the use of highly effective contraception, such as LARC methods (progestogen-only implant, copper intrauterine device, levonorgestrel intrauterine device), to reduce pregnancy risk .
    • Patients on Liver Enzyme-Inducing Drugs: Advise on potential interactions with hormonal contraception and offer reliable methods unaffected by enzyme-inducers (Cu-IUD, LNG-IUD, progestogen-only injectable) .
    • Post-Pregnancy/Abortion: Discuss contraception options with pregnant women for postnatal use, providing information on effective methods tailored to their needs . For young women post-abortion, discuss contraception as soon as possible, dispelling myths about fertility immediately after .
    • Patients with Learning/Physical Disabilities: Support them in making their own decisions about contraception . If unable to understand, establish a care plan with carers and involved parties .
  • Promote Safer Sex: Always promote safer sex, assess the risk for sexually transmitted infections (STIs), advise testing when appropriate, and provide information about local STI services .
  • Provide Interim Contraception: If required, supply an interim method of contraception at the first appointment .

Related Knowledge Topics

Educational content only. Always verify information and use clinical judgement.