A woman who is switching to a progestogen-only injectable from:

• Another hormonal method — excluding the levonorgestrel-releasing intrauterine system (IUS):
• The woman can have the first injection immediately, if she has been using her hormonal method consistently and correctly (unlicensed use), or if it is reasonably certain that she is not pregnant. There is no need to wait for the next menstrual period.
• If her previous method was another injectable, she should have the new progestogen-only injectable no later than when the original repeated injection would have been given.
• No additional contraceptive protection is needed.
• A non-hormonal method other than a copper intrauterine device (IUD):
• The woman can have the first injection immediately, if it is reasonably certain that she is not pregnant. There is no need to wait for the next menstrual period.
• If she is within 5 days of the start of menstrual bleeding, no additional contraceptive protection is needed.
• If it has been more than 5 days since menstrual bleeding started (unlicensed use), she must abstain from sex or use additional contraceptive protection (such as condoms) for the next 7 days.
• A copper IUD or the levonorgestrel-releasing intrauterine system (IUS):
• The woman can have the first injection within 5 days after the start of menstrual bleeding:
• No additional contraceptive protection is needed.
• The IUD or IUS can be removed at that time.
• The woman can also start at any other time (unlicensed use), if it is reasonably certain that she is not pregnant.
• The IUD or IUS may be removed 7 or more days later.
• It may be removed earlier provided that she has not been sexually active in the past 7 days and that additional precautions are taken for the next 7 days.
• If she is amenorrhoeic or has irregular bleeding, she can have the injection as advised for other amenorrhoeic women.

• These recommendations are based on guidelines published by the Faculty of Sexual and Reproductive Healthcare (FSRH), formerly the Faculty of Family Planning and Reproductive Healthcare (FFPRHC) [FFPRHC, 2002; FFPRHC, 2005a].
• the Faculty of Sexual and Reproductive Healthcare (FSRH), formerly the Faculty of Family Planning and Reproductive Healthcare (FFPRHC), considered that an injection given up to day 7 of the menstrual cycle results in a low risk of an ovulatory cycle that could lead to pregnancy.
• The need for additional contraceptive protection among those switching from another hormonal method will depend on the previous method used.
• There was some concern about the risk of pregnancy when removing an intrauterine device within a cycle where there has already been intercourse. That concern led to the recommendation that the device be left in place until the next menstrual period.
• Whereas an estimated 48 hours of use of the progestogen-only pill (POP) was deemed necessary to achieve contraceptive effect on cervical mucus, the time required for progestogen-only injectables to exert such an effect was uncertain.