Contraception options
- 08 Dec 2023
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Contraception options
- Updated on 08 Dec 2023
- 1 Minute to read
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HRT does not provide contraception unless a 52mg levonorgestrel intrauterine system (LNG-IUD) is in place for endometrial protection or if the combined contraceptive pill is being used instead of HRT.
In general, all women can stop contraception at 55 years when natural sterility can be assumed. Before this age, the need for contraception should be checked.
The summary table below has been adapted from FSRH guidance.
| Contraceptive method | Safety with HRT | Role in HRT | |
| 52 mg LNG IUD | Safe to use as contraception alongside oestrogen of choice | The Mirena coil is licensed for 4 years as the progestogen arm of HRT. However, the FSRH supports use of any 52 mg IUD for up to 5 years (outside of product license) | |
| Progestogen only injectable (DMPA) | Safe to use as contraception alongside HRT, although consider change to lower dose progestogen only method | Highly likely to be effective for endometrial protection with oestrogen as part of HRT, but cannot be recommended as unlicensed for this indication | |
| Progestogen only implant (IMP) | Safe to use as contraception alongside HRT | Cannot be recommended at the present time for endometrial protection as part of HRT as no evidence for efficacy | |
| Progestogen only pill (POP) | Safe to use as contraception alongside HRT | Desogestrel 75 mcg cannot be relied on as endometrial protection for HRT | |
| Combined hormonal contraception (CHC) | Do not use in combination with HRT | Can be used in eligible women <50 years as an alternative to HRT. However, HRT containing estradiol may be more beneficial in improving bone health and BP. Zoely and Qlaira are CHC pills that contain estradiol | Women should be advised to switch to a progestogen only method of contraception aged 50 years |
| Barrier methods | Safe to use as contraception alongside HRT. Some vaginal preparations interfere with confom integrity | None | |
References and Further Information:
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