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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.

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.

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).

The combined oral contraceptive Zoely® (Merck, Sharp, and Dohme Limited) has been licensed in Europe since 2011 and will be available in the UK from May 2013. Zoely will be the second UK combined oral contraceptive (COC) to contain estradiol and to be formulated as an extended regimen since the introduction of Qlaira® (Bayer plc.)

These Standards are recommended for organisations providing contraceptive/sexual and reproductive health (SRH) services, including pregnancy planning, pregnancy choices, abortion, prevention and treatment of sexually transmitted infections (STIs), as well as sexual wellbeing and health promotion.

This statement provides guidance on contraceptive options for women with prolactinoma

Please note, this guidance document has lapsed. Up to date guidance on this topic can be found at: http://www.rcgp.org.uk/clinical-and-research/clinical-resources/sexually-transmitted-infections-in-primary-care.aspx

NICE supports the use of hysteroscopic sterilisation provided that normal arrangements are in place for clinical governance and audit.

Please note this item was archived in June 2012

The above committees have agreed that Clinical Effectiveness Unit Guidance on use of contraceptives is guidance on “common practice” and “current practice” in the use of these medicines and devices. Therefore it is recommended that it may not be necessary for clinicians to document every occasion when a contraceptive preparation is prescribed outside the product licence if such use falls within current guidance issued by the Faculty’s Clinical Effectiveness Unit.