Method Specific

The guideline provides evidence-based recommendations and good practice points to enable clinicians to support individuals to make informed decisions about choosing and using IUC. It includes information on assessing suitability of IUC use for contraception, the risks and benefits of IUC and guidance for IUC procedures, complications and follow-up. Published March 2023.

Please read this guidance document in conjunction with any relevant clinical statements for this topic:

FSRH CEU Statement: Response to new study by Meaidi et al (2023) Venous thromboembolism with use of hormonal contraception and non-steroidal anti-inflammatory drugs (September 2023)

FSRH Response to new study on use of CHC and POC and breast cancer risk (March 2023)

FSRH CEU Response to published study: Maternal use of hormonal contraception and risk of childhood leukemia: a nationwide, populate-based cohort study (September 2018)

FSRH CEU Statement to published systematic review: The relationship between progestin hormonal contraception and depression: a systematic review (March 2018)

FSRH CEU Statement: Response to Study Contemporary Hormonal Contraception and the Risk of Breast Cancer (December 2017)

FSRH CEU Statement: Response to Study: Intrauterine Contraception Use and Cervical Cancer Risk (January 2018)

FSRH CEU Statement: Contraception and Weight Gain (August 2019)

The digital version can be accessed from the BMJ SRH website: FSRH Guideline (March 2023) Intrauterine contraception BMJ Sexual & Reproductive Health 2023;49:1-142. 

This FSRH Statement provides guidance to support clinical practice during copper intrauterine shortages.

Manufactured by OCON Medical Ltd, the Intrauterine Ball (IUB™) SCu300B MIDI is a copper intrauterine device (Cu-IUD) comprised of copper beads with a total exposed copper surface of 300mm² strung on a flexible Nitinol (nickel/titanium alloy), PET-coated frame. Once the IUB is released from the 3.2mm diameter insertion tube into the uterus it coils into a spherical shape measuring 15mm in diameter. Download the product review in full here.

This statement provides guidance on antibiotic cover for urgent insertion of intrauterine contraception in women at high risk of STI. Download the full document here.

This statement notes that the Levosert® 52mg LNG-IUS has been licensed for contraceptive use for 6 years. Levosert remains licensed for 5 years for management of heavy menstrual bleeding and is not licensed for endometrial protection as part of HRT.

This statement relates to a field safety notice released by intrauterine device manufacturer Eurogine in 2018 and 2019.

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.

This document was updated in March 2019. The FSRH CEU has produced a new product review for Kyleena which summarises the key differences in the product and clinical characteristics between Kyleena and other LNG-IUS available in the UK.

Benilexa® (Gedeon Richter) - a 52mg levonorgestrel-releasing intrauterine system (LNG-IUS) with a reloadable one-handed insertion device - is now available in the UK. Benilexa is licensed for 6 years of use for contraception. It is not licensed for endometrial protection as part of HRT. This FSRH CEU Resource provides a table which compares the product characteristics of LNG-IUS devices currently available in the UK, Benilexa®, Levosert®, Mirena®, Kyleena® and Jaydess®.

Recent media reports have highlighted cases of individuals who have experienced distressing intrauterine contraception (IUC) fitting. Read and download the FSRH statement on pain associated with intrauterine contraception.

This guidance provides evidence-based recommendations and good practice points for health professionals on the use of progestogen-only implants currently available in the UK. It is intended for any health care professional or health service providing contraception or conception advice in the UK.

Please read this guidance document in conjunction with any relevant clinical statements for this topic:

FSRH CEU Statement: Response to new study by Meaidi et al (2023) Venous thromboembolism with use of hormonal contraception and non-steroidal anti-inflammatory drugs (September 2023)

FSRH Response to new study on use of CHC and POC and breast cancer risk (March 2023)

FSRH CEU Response to published study: Maternal use of hormonal contraception and risk of childhood leukemia: a nationwide, populate-based cohort study (September 2018)

FSRH CEU Statement to published systematic review: The relationship between progestin hormonal contraception and depression: a systematic review (March 2018)

FSRH CEU Statement: Response to Study Contemporary Hormonal Contraception and the Risk of Breast Cancer (December 2017)

FSRH CEU Statement: Contraception and Weight Gain (August 2019)

The digital version can be accessed from the BMJ SRH website: FSRH Guideline (February 2021) Progestogen-only Implant. BMJ Sexual & Reproductive Health 2021; 47:Suppl 1. 

This CEU Statement provides guidance to healthcare professionals in response to a letter circulated by MSD (manufacturer of Nexplanon®) to healthcare professionals in the UK about updated guidance regarding the recommended Nexplanon® insertion site.

This guidance provides evidence-based recommendations and good practice points for health professionals on the use of progestogen-only injectables (depot medroxyprogesterone acetate (DMPA), Depo-Provera) currently available in the UK. It is intended for any health care professional or health service providing contraception or conception advice in the UK.

Please read this guidance document in conjunction with any relevant clinical statements for this topic:

FSRH CEU Statement: Response to new study by Meaidi et al (2023) Venous thromboembolism with use of hormonal contraception and non-steroidal anti-inflammatory drugs (September 2023)

FSRH Response to new study on use of CHC and POC and breast cancer risk (March 2023)

FSRH CEU Response to published study: Maternal use of hormonal contraception and risk of childhood leukemia: a nationwide, populate-based cohort study (September 2018)

FSRH CEU Statement to published systematic review: The relationship between progestin hormonal contraception and depression: a systematic review (March 2018)

FSRH CEU Statement: Response to Study Contemporary Hormonal Contraception and the Risk of Breast Cancer (December 2017)

FSRH CEU Statement: Contraception and Weight Gain (August 2019)

The CEU supports the self administration of Sayana Press® because of its potential benefits to women and services. It offers women greater choice and more autonomy over their contraception and fertility.

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).

This guideline provides evidence-based recommendations and good practice points for health professionals on the use of progestogen-only contraceptive pills. It is intended for any health care professional or health service providing contraceptive care in the UK.

Please read this guidance document in conjunction with any relevant clinical statements for this topic:

FSRH CEU Statement: Response to new study by Meaidi et al (2023) Venous thromboembolism with use of hormonal contraception and non-steroidal anti-inflammatory drugs (September 2023)

FSRH Response to new study on use of CHC and POC and breast cancer risk (March 2023)

FSRH CEU Response to published study: Maternal use of hormonal contraception and risk of childhood leukemia: a nationwide, populate-based cohort study (September 2018)

FSRH CEU Statement: Oral Contraceptives and Multiple Sclerosis (March 2014)

FSRH CEU Statement to published systematic review: The relationship between progestin hormonal contraception and depression: a systematic review (March 2018)

FSRH CEU Statement: Response to Study Contemporary Hormonal Contraception and the Risk of Breast Cancer (December 2017)

FSRH CEU Statement: Contraception and Weight Gain (August 2019)

Also available in digital format on the BMJ website: FSRH Guideline (August 2022) Progestogen-only Pills. BMJ Sexual & Reproductive Health 2022; 48:Suppl 1.

This FSRH Statement reviews two desogestrel 75mcg progestogen-only pill (POP) available over-the-counter as Pharmacy Medicines.

This guidance provides evidence-based recommendations and good practice points for health professionals on the use of combined hormonal contraceptives (i.e. the combined oral contraceptive pill, transdermal patch and combined vaginal ring) currently available in the UK. It is intended for any health care professional or health service providing contraception or conception advice in the UK.

Please read this guidance document in conjunction with any relevant clinical statements for this topic:

FSRH CEU Statement: Response to new study by Meaidi et al (2023) Venous thromboembolism with use of hormonal contraception and non-steroidal anti-inflammatory drugs (September 2023)

FSRH Response to new study on use of CHC and POC and breast cancer risk (March 2023)

FSRH CEU Statement: New manufacturer/MHRA advice regarding nomegestrol acetate – how does this affect prescribing of Zoely®? (April 2023)

FSRH CEU Statement : New advice from the MHRA regarding cyproterone acetate: how does this affect prescribing of Co-cyprindiol/Dianette® for acne/hirsutism? July 2020

FSRH CEU Response to published study: Maternal use of hormonal contraception and risk of childhood leukemia: a nationwide, populate-based cohort study (September 2018)

FSRH CEU Statement: Oral Contraceptives and Multiple Sclerosis (March 2014)

FSRH CEU Statement: Response to Study Contemporary Hormonal Contraception and the Risk of Breast Cancer (December 2017)

FSRH CEU Statement: Contraception and Weight Gain (August 2019)

FSRH CEU Statement: Response to new reports of link between COC and Glaucoma (November 2013)

The digital version can be accessed from the BMJ SRH website: FSRH Guideline (January 2019, amended November 2020) Combined Hormonal Contraception. BMJ Sexual & Reproductive Health 2019; 45:Suppl 1.

This document provides guidance on incorrect use of: combined oral contraceptive pills, the combined vaginal ring, and the combined transdermal patch. This guidance was developed with an international team of SRH experts. The panel used the limited relevant published evidence relating to risk of pregnancy associated with incorrect use of the combined pill, patch and ring to inform a set of rules that are overcautious, but are considered to be simple enough to make them usable in practice. The guidance was peer reviewed and went out to public consultation prior to final publication. The guidance is intended for use by health professionals working in SRH, general practice and obstetric and gynaecology settings, and can also be used by women using CHC. Download the document here.

FSRH CEU new product review: Drovelis® estetrol/drospirenone combined oral contraceptive (October 2022).

This FSRH Statement responses to a recently published cohort study, which used information from Finnish databases, assessed incidence of confirmed venous thromboembolic (VTE) events in 2018/19 amongst the roughly 300,000 Finnish people aged 15-49 who were using hormonal contraception (HC) in 2017 (identified from the prescribing database) and age-matched controls who were not using hormonal contraception.

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.

How effective is 20mcgEE/3mgDRSP as contraception? 20mcgEE/3mg DRSP is of comparable effectiveness to other combined oral contraceptives. [1,2,3] A large US observational study reports lower failure rates amongst users of a 24/4 EE/DRSP regimen than a 21/7 EE/DRSP regimen. The study also suggests greater contraceptive effectiveness of a 24/4 EE/DRSP regimen than with a 24/4 regimen containing EE in combination with norethisterone.

This FSRH Satement notes the availability and dispensive of the combined vaginal contraceptive rings in the UK.

This guidance provides evidence-based recommendations and good practice points for health professionals on the use of barrier methods for contraception and STI prevention. It is intended for any health care professional or health service providing contraception or conception advice in the UK.

The Faculty of Sexual and Reproductive Healthcare (FSRH) has been made aware that the Reflexions® flat spring diaphragm range, manufactured by Williams Medical, is being discontinued in the UK.

Diaphragms are non-hormonal barrier methods of contraception that protect women against pregnancy by preventing sperm reaching the cervix. A single size contraceptive cap, FemCap, has been available since 2004, but until recently diaphragm products have been made in a range of sizes and designs. As a result women may have been required to try several types of diaphragm during the fitting process.

This guidance provides evidence-based recommendations and good practice points for health professionals on elective male sterilisation (vasectomy) and female sterilisation (tubal occlusion) in the UK. It is intended for any health care professional or service that undertakes or refers individuals for either procedure. This guidance has been jointly developed with the Royal College of Obstetricians and Gynaecologists (RCOG).

This is a summary of the recommendations made in the FSRH Clinical Guidance Male and Female Sterilisation. This guidance has been jointly developed with the Royal College of Obstetricians and Gynaecologists (RCOG).

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

Essure® is a form of female sterilisation which involves the hysteroscopic insertion of flexible micro-inserts into the proximal section of the fallopian tubes and is undertaken without general anaesthesia.

A large observational study from the United States found that the risk of unintended pregnancy after Essure sterilisation was similar to that after surgical sterilisation. However just over 2% of women who had Essure sterilisation required a further operation related to the sterilisation procedure within a year.

This is a new guidance document that provides evidence-based recommendations and good practice points on the use of fertility awareness methods (FAM) for the purpose of preventing and/or spacing pregnancies. It is intended for any health care professional or health service providing contraception or conception advice in the UK.

A new mathematical model suggests that effective suppression of ovulation for contraception could be achieved using lower doses of progestogen and estrogen than those currently used in hormonal contraceptives. A paper published today in PLOS Computational Biology describes the model and its findings. The authors highlight that lower exposure to exogenous hormones could reduce associated health risks and side effects. The model could be used to inform dose and regimen of exogenous hormones to be investigated by future clinical trials seeking to find new options for safe, effective and acceptable contraception. Clinical trials would be required to investigate what outcomes, with such regimens, were found in practice.

The National Institute for Health and Care Excellence (NICE) has decided not to update their 2005 guidance on long-acting reversible contraception (LARC) at this time because changes to the current recommendations are not required.