Contraception: Your Questions Answered

This seventh edition has been completely revised and updated, incorporating relevant WHO and national guidance documents: therefore imparting best evidence-based practice for all methods.

• Combined oral contraceptives (COCs) Based on the long-established evidence that 7 days of routinely not-taking pills in each cycle is too long for maintained ovarian suppression - and this necessarily leads to too little margin for errors in pill-taking - the authors recommend that providers switch to a new norm for all users of either:
  • Tricycling, the 84/4 regimen, or totally continuous use (365/365),
  • OR, for women who remain keen to see monthly pill-bleeds (which are completely unnecessary for health), one of the regimens (24/4 or 21/4) that shorten the contraception-non-taking time to 4 days
• New methods, and their importance or otherwise:
  • Intrauterine system: Jaydess�
  • Subcutaneous, self-injectable alternative to Depo-Provera: Sayana� Press
  • 24/4 combined hormonal contraceptives: Zoely�, Eloine�
  • Diaphragm: Caya�
• Updates
  • Quick starting and bridging (the Proving not Pregnant Protocol)
  • Emergency contraception (EC), how advice differs for ulipristal acetate EC
  • Drug metabolism (implications with norethisterone) and interactions (eg affecting lamotrigine)