In one sense, all family planning options are long-term because family planning is a right and responsibility that lasts decades in most people's lives. However, contraceptive methods are not usually called long-term if they require action every day, like the pill, or every time you have sex, like condoms. Long-term family planning methods work for weeks, months, years or a lifetime.
Significance
At any given time, most people are using short-term methods of contraception. Yet long-term methods take up a substantial share of family planning worldwide. During 2007, 41 percent of family planning users globally relied on long-term methods, both irreversible and reversible ones, suggesting their appeal to both couples who were spacing children and those who had completed their families.
Types
Fertility returns quickly for most women if and when they discontinue the reversible methods of long-term family planning methods. The copper-bearing IUD is a small, copper-wrapped plastic device that a trained health worker inserts into a woman's uterus through her vagina and cervix. It works up to 12 years. Progestin implants are inserts under the skin that last from three to seven years. You can take progestin-only injections every two to three months. You can take combined (progestin/estrogen) contraceptives as monthly injections; in rings you wear over the cervix three weeks and remove for one; and from skin patches you wear three weeks and take off for one.
The permanent long-term family planning methods are male and female sterilization surgeries. Tubal ligation cuts or blocks a woman's Fallopian tubes, the passages between her ovaries and uterus where conception takes place. Vasectomy cauterizes, cuts or blocks a man's vas deferens, the tubes that transport sperm cells into his semen.
Misinformation
Misinformation about long-term methods may keep people from considering whether these might meet their needs. For example, some women fear that tubal ligation will disrupt their menstrual cycles or sex drives. Some men believe that vasectomy will leave them impotent or harm their libidos.
Many believe that hormonal contraceptives and IUDs all prevent implantation of a newly conceived life into the uterine lining and thus cause very early abortions. However, copper-bearing IUDs appear to work before conception, by damaging sperm and hindering their movement. Combined progestin/estrogen contraceptives suppress ovulation and thicken cervical mucus so that sperm cannot pass through. Progestin-only methods suppress ovulation less efficiently, but their mucus-thickening effect still makes conception quite unlikely.
Benefits
Beyond the appointments they require with health care providers, long-term family planning methods require little effort on the part of users. Yet they are among the most highly effective of all birth control methods. When used correctly and consistently, all of them are over 99 percent successful at preventing pregnancy.
Cautions
All family planning methods have risks and unintended pregnancy rates, however small. Yet male and female sterilization are for people who do not want to have any or any more children. Reversal surgeries are expensive and seldom result in pregnancy.
No long-term family planning methods protect against sexually transmitted diseases like HIV/AIDS. You can use these methods with condoms. However, IUDs are generally not a good choice for women at risk of sexually transmitted diseases.
