Combined Hormonal Contraception

FSRH Clinical Guideline: Combined Hormonal Contraception (January 2019, Amended November 2020)

01 November 2020

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.

This document is up-to-date

FSRH CEU Guidance: Combined Hormonal Contraception Quick Reference Summary (January 2019, amended November 2020)

01 November 2020

This summary has been written as a quick reference guide to help busy clinicians to give clear, safe advice on combined hormonal contraception (CHC). Please refer to the full 2018 FSRH CHC Clinical Guideline for further information and evidence for this advice. This document is written for FSRH members and requires you to log in to access it.

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FSRH CEU Guidance: Recommended Actions after incorrect Use of Combined Hormonal Contraception (e.g. late or missed pills, ring and patch) (March 2020, amended July 2021)

16 March 2020

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.

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FSRH CEU Statement: Strengthening of Warnings about use of Dianette and other brands of co-cyprindiol (June 2013)

01 June 2013

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.

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FSRH New Product Review: Eloine Daylette (November 2015)

01 November 2015

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.

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FSRH New Product Review: Estradiol/Nomegestrol Combined Pill, Zoely© (May 2013)

01 May 2013

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.)

This document is up-to-date