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Contraception - How up-to-date is this topic?
Changes

Version 1.19, revision planned in 2011.

Last revised in September 2007

February 2011 — minor update. The Faculty of Sexual and Reproductive Healthcare no longer recommend that additional contraceptive precautions are required during or after courses of antibiotics that do not induce liver enzymes. However, additional contraceptive precautions are required if the antibiotic or illness causes vomiting or diarrhoea [FSRH, 2011]. Issued in February 2011.

December 2010 — minor update. Type B diaphragms BS 4028 Type 1 (coil spring) are no longer listed in the Drug Tariff. Prescriptions have been removed. Note that the Milex omniflex® coil spring diaphragms are still available to prescribe. Issued in January 2010.

November 2010 — minor update. Advice from the Faculty of Sexual & Reproductive Healthcare (FSRH) guideline Quick starting contraception has been included in this topic. Issued in November 2010.

October 2010 — minor update. From mid-October 2010, Nexplanon® will replace Implanon® as the only progestogen-only implant licensed for use in the UK. Nexplanon® and Implanon® are bioequivalent (both contain 68 micrograms etonogestrel, have the same release rate, and provide contraception for 3 years). The main differences are that Nexplanon® is radio-opaque, and has a different application device and insertion technique (training is required) [FSRH, 2010]. Issued in October 2010.

September 2010 — minor update. Prescriptions for the following new combined oral contraceptive pills have been included: Rigevidon® (ethinylestradiol plus levonorgestreol), Gedarel® (ethinylesteradiol plus desogestrel), Millinette® (etihyletradiol plus gestodene), and Triregol® (triphasis ethinylestradiol plus levonorgestrel). Issued in September 2010.

August 2010 — updated. The section on contraceptive choices in women approaching the menopause has been updated to include the Faculty of Sexual and Reproductive Healthcare (FSRH) guidance on Contraception in women aged over 40 years [FSRH, 2010]. Issued in August 2010.

June 2010 — updated. The section on contraceptive choices in young women under 18 years of age has been updated in line with the Faculty of Sexual and Reproductive Healthcare (FSRH) guidance on Contraceptive choices for young people [FSRH, 2010]. A prescription for Levest®, a new ethinylestradiol plus levonorgestrel combined oral contraceptive pill, has been added. Issued in June 2010.

April 2010 — minor update. Advice from the Medicines and Healthcare products Regulatory Agency (MHRA) that the risk of venous thromboembolism associated with Yasmin® is higher than COCs containing levonorgestrel, but lower than with COCs containing desogestrel or gestodene has been added [MHRA, 2010]. Issued in April 2010.

March 2010 — minor update. Prescribing information sections updated in line with the Faculty of Sexual and Reproductive Healthcare (FSRH) statement on antiepileptic drugs and contraception [FSRH, 2010]. Advice regarding assessment of young women aged under 24 years with abnormal vaginal bleeding also added [DH, 2010]. Issued in March 2010.

February 2010 — updated to include the revised UK medical eligibility criteria for contraceptive use, as published by the Faculty of Sexual and Reproductive Healthcare (FSRH), formerly the Faculty of Family Planning and Reproductive Healthcare (FFPRHC) [FSRH, 2009]. Issued in January 2010.

October 2009 — updated to include the combined contraceptive vaginal ring, on the basis of the Summary of Product Characteristics for NuvaRing® [ABPI Medicines Compendium, 2009a], and a Faculty of Sexual and Reproductive Healthcare (FSRH), (formerly the Faculty of Family Planning and Reproductive Healthcare[FFPRHC]), New product review [FSRH, 2009]. The advice about when to a remove a copper intrauterine device or a levonorgestrel-releasing intrauterine system in a woman with pelvic inflammatory disease has also been updated. Minulet® and Tri-Minulet® have been discontinued and prescriptions have been removed. Issued in October 2009.

June 2009 — minor update. Correction to prescription title. Issued in June 2009.

April 2009 — minor update. The Summary of Product Characteristics (SPC) for Evra® transdermal patches now states that the patch releases 203 micrograms of norelgestromin and 33.9 micrograms of ethinylestradiol per 24 hours. The Description of patch section has been updated accordingly. Issued in May 2009.

March 2009 — minor update. The Quality and Outcomes Framework (QOF) indicators for sexual health have been updated in the Goals and outcome measures section. Issued in April 2009.

February 2009 — updated to include recent guidance from the Faculty of Sexual and Reproductive Healthcare (FSRH), formerly the Faculty of Family Planning and Reproductive Healthcare (FFPRHC), on Progestogen-only pills and Progestogen-only injectable contraception; advice on when to suspect uterine perforation following insertion of an intrauterine device or system has been updated; and the upper age limits on the prescriptions for combined oral contraceptive pills have been changed to 50 years. Issued March 2009.

December 2008 — minor update. All-flex® latex diaphragms (all sizes) have been discontinued. Text has been updated and prescriptions removed. Issued in January 2009.

November 2008 — minor update. Black triangle removed from Evra® patches. Issued in December 2008.

September 2008 — minor correction. Typographical and table heading corrections to UK medical eligibility criteria tables on Copper intrauterine devices and Levonorgestrel-releasing intrauterine system. Issued in September 2008.

May 2008 — update to text to reflect new guidance from the Faculty of Sexual and Reproductive Healthcare (FSRH), formerly the Faculty of Family Planning and Reproductive Healthcare (FFPRHC), on Intrauterine Contraception 2007 and Progestogen only implants 2008. Issued June 2008.

April 2008 — minor update. Trinordiol has been discontinued. Prescriptions have been removed and a minor change in text has been made.

March 2008 — minor update. Ortho-creme® has been discontinued. Prescriptions for Ortho-creme® have been removed and replaced with Gygel®. Issued March 2008.

April to September 2007 — converted from PRODIGY guidance to CKS topic structure. The evidence-base has been reviewed in detail, and recommendations are more clearly justified and transparently linked to the supporting evidence.

This topic has been rewritten to incorporate recommendations issued by:

  • National Institute for Health and Clinical Excellence
    • Long acting reversible contraception: the effective and appropriate use of long-acting reversible contraception (October 2005)
  • Faculty of Sexual and Reproductive Healthcare (FSRH), formerly the Faculty of Family Planning and Reproductive Healthcare (FFPRHC)
    • Combined Oral Contraception - First Prescription of COC (January 2007)
    • Combined Oral Contraception - Missed Pills (April 2005)
    • Condoms - Male and Female (January 2007)
    • Contraception for women aged over 40 years (January 2005)
    • Contraceptive choices for breastfeeding women (2004)
    • Contraceptive choices for young people (2004)
    • Drug interactions with hormonal contraception (April 2005)
    • Emergency contraception (2006)
    • Faculty statement from the CEU on a new publication: WHO selected practice recommendations for contraceptive use update. Missed pills: new recommendations (2005)
    • Faculty statement from the CEU on changes to prescribing information for lamotrigine. Female barrier methods (July 2007)
    • Lamotrigine and interactions with hormonal contraceptives (August 2005)
    • New product review: Desogestrel-only pill (Cerazette®) (2003)
    • New product review: Norelgestromin/ethinyl oestradiol transdermal contraceptive system (Evra®) (September 2003)
    • Statement on MHRA guidance on Depo-Provera® (2004)
    • The copper intrauterine device as long-term contraception (2004)
    • The levonorgestrel-releasing intrauterine system (LNG-IUS) in contraception and reproductive health (2004)
    • The management of women of reproductive age attending non-genitourinary medicine settings complaining of vaginal discharge (2006)
    • The use of contraception outside the terms of the product licence (July 2005)
    • UK Medical Eligibility Criteria for Contraceptive Use (2005/2006)
    • UK selected practice recommendations for contraceptive use (2002)

In addition Orthoform® contraceptive pessaries have been discontinued by the manufacturer and the prescription has been removed.

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