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This guidance provides evidence-based recommendations and good practice points for health professionals providing contraceptive services to women with cardiac disease in the UK.

With the introduction of the process of revalidation for doctors, appraisal has been standardised and this has been supported by the Medical Appraisal Guide, Model Appraisal Form Guidance for this has already been published by the Royal College of Obstetricians and Gynaecologists and Faculty of Sexual and Reproductive Healthcare outlining what supporting evidence should be provided at appraisal.

Jaydess® is a levonorgestrel intrauterine system (LNG-IUS) newly launched in the UK for contraception. It is a smaller, lower dose version of the Mirena® LNG-IUS.

A quality contraceptive service is vital in giving women and men of all ages choice and control over their reproduction, and is key to avoiding unplanned pregnancies and planning families. Contraception is a highly cost-effective intervention, which plays an important public health role in improving the lives of individuals, families and communities.

Various news stories have reported the findings detailed in the AAN press release which stated that compared to women who did not use hormonal contraceptives, women who did, were 35 percent more likely to develop Multiple Sclerosis and that the findings suggested that hormonal contraception may be contributing to the rise in the rate of MS among women.

An article published in the British Medical Journal (BMJ) in November 2013, questioned whether women with HIV, or at high risk of contracting HIV, should use progestogen-containing contraceptives.

St Johns wort is a herbal product that is used for depressive symptoms and is known to have enzyme-inducing effects on cytochrome p450 enzymes. The MHRA statement highlights that in the last quarter of 2013, two ‘Yellow Card’ reports were received relating to unplanned pregnancies, in women with progestogen-only implants, suspected to be the result of an interaction with St John’s wort.

Following a presentation at the annual meeting of the American Academy of Ophthalmology a number of media reports have reported a possible link between use of combined oral contraception (COC) and glaucoma. There is limited data investigating combined hormonal contraceptives on glaucoma. One cohort study suggested that 5 or more years of COC use was associated with a 25% increase in the risk of glaucoma. Two UK cohort studies did not find consistent evidence of an increased risk.

Injectable progestogen-only contraception is a popular and effective method of contraception and until now, in the UK has largely been administered as Depo-Provera®, an intramuscular (IM) injection of 150mg medroxyprogesterone acetate (DMPA).

Following a recent safety review, a letter has been issued to healthcare professionals from the manufacturers of Dianette® and other cyproterone acetate 2 mg/ ethinylestradiol 35 mcg (co-cyprindiol) products. The review by the Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medicines Agency (EMA) followed concerns about the risk of thrombosis associated with co-cyprindiol. With the agreement of the EMA and Medicines and Healthcare products Regulatory Authority (MHRA), a letter has been issued to raise awareness of the thrombosis risks and the outcome of the review.