How should I counsel patients regarding the potential side effects and benefits of different LARC methods?

Counselling patients on long-acting reversible contraception (LARC) methods should involve providing detailed, tailored information to support informed decision-making. This includes discussing the contraceptive efficacy, duration of use, risks and possible side effects, non-contraceptive benefits, and the procedures for initiation and removal of each method.

Patients should be informed about common side effects such as changes in bleeding patterns, which may include irregular bleeding or amenorrhoea; these effects can be perceived differently depending on individual and cultural preferences.

For intrauterine contraception (IUC), patients should be advised to check for device threads regularly and be aware that IUCs do not protect against sexually transmitted infections (STIs), so barrier methods should be used for STI prevention.

Patients must be counselled on when to seek medical advice, such as if they experience symptoms of pelvic infection, persistent bleeding abnormalities beyond six months, discomfort during intercourse, or suspect pregnancy.

Healthcare professionals should ensure counselling is sensitive to cultural and religious beliefs and provide information in accessible formats, including verbal and written materials, and use interpreters or advocates as needed.

Medical history and eligibility assessments should be conducted to tailor contraceptive choices safely, considering comorbidities, personal preferences, and any contraindications.

Finally, patients should be reassured about the reversibility of LARC methods and informed about the return to fertility after discontinuation.

Overall, counselling should empower patients to choose the most acceptable and suitable LARC method for their individual needs, ensuring informed consent and ongoing support.

References: ¹,²,³,⁴