Standards & guidance

This FSRH Statement responses to a recently published study by Meaidi et al. published on 06/09/2023 which used data from nationwide Danish databases to compare risk of first VTE events during use of hormonal contraception (HC) with that during concomitant use of HC and the non-steroidal anti-inflammatory drugs (NSAIDs) ibuprofen, diclofenac or naproxen.

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.

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 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 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)

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 .

A study published today in the Lancet reports that a combination of levonorgestrel 1.5mg with piroxicam is more effective for emergency contraception than levonorgestrel 1.5mg alone.

This document updates previous Faculty of Sexual & Reproductive Healthcare (FSRH) guidance and aims to summarise the available evidence on emergency contraception (EC). The guidance is intended for use by health professionals providing EC.  Please read this guidance document in conjunction with any relevant clinical statements for this topic: FSRH CEU Statement Response to Edelman 2022 (August 2022) FSRH CEU Statement: Response to Endler 2022 (July 2022) FSRH CEU Statement: Combined oral contraceptive interference with the ability of ulipristal acetate to delay ovulation: A prospective cohort study (August 2018) FSRH CEU response to European Medicines Agency recommendations regarding use of ulipristal acetate for management of uterine fibroids (February 2018) FSRH CEU Statement: Response to Recent Publication Regarding Banh, et al - November 2020 FSRH CEU Statement: Response to Recent Publication Turok et al. (2021) - February 2021

This update of the 2010 Contraception for Women Aged Over 40 Years guideline has been developed by the FSRH and brings together evidence and expert opinion on contraception for women aged over 40 years. The guideline was developed with a team of experts in the relevant fields and has been extensively peer reviewed in accordance with methodology used for developing FSRH Clinical Guidelines. The guidance is intended for use by health professionals working in SRH, general practice and obstetric and gynaecology settings.