Contraception overview & assessment / MEC

• Contraceptives (MIMS), ​Contraception - assessment (CKS), Family planning: a global handbook for providers (WHO, 2011), Your contraception guide (NHS Choices), Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists (FSRH), Which contraception is right for me? (your-life)

• ​Medical Eligibility Criteria (MEC): UK Medical Eligibility Criteria (MEC) (FSRH, 2016), United States Eligibility Criteria (US MEC) for Contraceptive Use, 2016 (CDC), Medical eligibility criteria for contraceptive use (WHO, 2015)​​

• Combined Oral Contraceptive Pill (COCP): Co-cyprindiol (Dianette) not licensed for contraception due to risk of VTE, although it may be used for severe acne or hirsutism. Combined hormonal contraception can be started on any day of the menstrual cycle – however if starting on day six or later, additional precautions are necessary for the first seven days. Combined hormonal methods (CKS), Combined pill (NHS Choices)​. MEC 3: VTE in first deg relative <45Y. Avoid COCP with strong enzyme inducers (e.g. rifampicin/rifabutin): Drug Interactions with Hormonal Contraception. (FSRH)

• Patch: Contraceptive patch (NHS Choices)​, Transdermal - standard strength (BNF)

• Ring: Vaginal - low strength (BNF)

• Progesterone-only contraception: Progesterone-only methods (CKS), ​Parenteral progesterone-only contraceptives (BNF)

• Progesterone-only pill (POP): Progesterone-only pill (NHS Choices), Oral progesterone-only contraceptives (BNF)

• Barrier methods: Contraception - barrier methods and spermicides (CKS)​, Condoms (NHS Choices), Contraceptive diaphragm (NHS Choices)​

• Natural family planning: Contraception - natural family planning (CKS), Natural family planning (NHS Choices)​, Does the evidence support global promotion of the calendar-based Standard Days Method of contraception? (Contraception, 2016)

Long-Acting Reversible Contraception (LARC) and Permanent

• Implant: <25% regular bleeds. 33% infrequent bleeding; 1/5 no bleeding; 25% prolonged or frequent bleeding. Altered bleeding patterns are likely to remain irregular. Progestogen-only Implants (FSRH), Contraceptive implant (NHS Choices)

• Injection: Contraceptive injection (NHS Choices)

• Intra-Uterine System (IUS): IUS (NHS Choices) Non-hormonal contraception

• Intra-Uterine Device (IUD): licensed for either 5 or 10 years of use. Extended use of the IUD when inserted at ≥ 40 An IUD inserted after age 40 can remain in situ until 1 year after the last menstrual period (LMP) if it occurs when the woman is 50 or older. If a woman is under 50, the IUD can remain in situ for two years after the LMP. Contraception for women over 40 (FSRH), Contraception - IUS/IUD (CKS), Intra-uterine devices (BNF), IUD (NHS Choices)

• Permanent contraception: Contraception - sterilization (CKS), Female sterilisation (NHS Choices), Male sterilisation - vasectomy (NHS Choices)

Emergency Contraception (EC)​ / Missed Pills

• Levonorgestrel 1.5mg [3mg if on enzyme inducer or overweight] (72 hr/3D window); IUD (up to 120 hrs/5D) after the expected day of ovulation (up to D19 in 28D cycle)

• Emergency contraception (NHS Choices), Contraception - emergency (CKS), Emergency Contraception (Patient.info), Quick starting contraception (FSRH, 2010)

• Missed contraceptive pills​: Missed contraceptive pills (patient.info)