1. Ruth Adams Clinical Practice Educator LLR Sexual Health
LARC Update
Ruth Adams
Clinical Practice Educator
LLR Sexual Health

2. Why use LARC?

3. Introducing Sayana Press

4. About Sayana Press
S/C injection of 104mg in 0.65ml Medroxyprogesterone Acetate
Product licence is for 13 weeks
Has licence for self-administration
In women with deep adipose tissue in the gluteal area, standard-length needles may not reach the muscle layer and SC DMPA or deltoid administration of IM DMPA should be considered.
SC DMPA should be injected into the abdomen or anterior thigh.

5. Self Administration
Saves women having to attend surgery every 3 months.
Missing appointments can put women at risk of pregnancy
Self-administration may reduce this risk.
Women need training and must be supervised by a HCP when administering the first dose.
They can then be given supply of three further injections and reviewed in surgery every year.
Who is suitable?

6. Video

7. Practicalities of Self Administration
HCP guides etc can be ordered at
Patient specific website
Patient website allows to sign up for text reminder
Sharps bins will be required at home

8. Introducing Jaydess

9. Comparison with Mirena
28mm width
Silver Ring
30mm length
6 micrograms/24 hours
Up to 3 years contraceptive cover
Smallest IUS
Insertion tube diameter 3.8mm
levonorgestrel
20 micrograms/24 hours
Up to 5 years contraceptive cover
Treatment for HMB
HRT for up to 4 years
Insertion tube diameter 4.4mm
32mm width
32mm length

10. About Jaydess 90% of women with Jaydess have monthly menses
No difference in reported hormonal side effects compared to Mirena.
Found to be less painful to fit than Mirena
Increasingly popular with young women who are nulliparous.
Popular with women who want regular periods.
Product license is for contraception only
Includes risk management, programme management, different approach to complaints
Next phase of board development being designed

11. Ectopic pregnancy with IUD/IUS
Previous ectopic is UKMEC 1 Because risk of pregnancy is very low, risk of ectopic is also very low approx. 1 in 1000 at 5 years However of those pregnancies a higher proportion are ectopic some studies suggest 9% whilst others up to 53% Ectopic rate of Jaydess is currently 50% but expected to reduce due to small number of pregnancies in study

12. Any Questions?

23. Anecdotal evidence that history of one expulsion increases risk of subsequent expulsion
Risk of ectopic pregnancy with any IUC at 5 years is approx. 1:1000