Start times and switching from other contaceptives
DGRefHelp - NHS Dumfries & Galloway
Warning
Start times
| Circumstances for CHC start | When to start | Additional contraceptive precautions required |
|---|---|---|
| Women having menstrual cycles |
Start CHC up to and including Day 5 (day 1 for Qlaira®) | None |
| At any other time if it is reasonably certain that she is not pregnant (see Quick start guideline) | For 7 days 9 days for Qlaira® |
|
| Women with secondary amenorrhoea |
At any time, if it is reasonably certain that she is not pregnant | For 7 days 9 days for Qlaira® |
| Postpartum | ||
| Not breastfeeding |
With no additional risk factors for VTE (UKMEC 2) from 3 weeks. With additional VTE risk factors (UKMEC 3)- from 6 weeks |
For 7 days 9 days for Qlaira® |
| If >21 days postpartum and cycles have not returned as for other amenorrhoeic women. | For 7 days 9 days for Qlaira® |
|
| Breastfeeding | From 6 weeks postpartum | For 7 days 9 days for Qlaira® |
| Post abortion | Up to and including day 5 post medical or surgical abortion <24 weeks gestation (day 1 for Qlaira®) |
None |
Switching from other contraceptive methods
| All Hormonal methods except IUS * |
CHC can be started immediately if hormonal method used consistently and correctly, or if it is reasonably certain she is not pregnant. If previous method injectable or implant can start CHC at any time up to when repeat injection due or implant removed (not expired) |
None if previous method reliably suppresses ovulation If POP(other than Desogestrel) for 7 days (9 days if Qlaira®) |
| Switching from LNG-IUD | CHC can be started immediately. Removal of IUS is not recommended if unprotected intercourse has occurred in the last 7 days due to risk of pregnancy |
CHC can be started immediately. Removal of IUS is not recommended if unprotected intercourse has occurred in the last 7 days due to risk of pregnancy For 7 days (9 days for Qlaira®) Or defer removal of IUS until new method effective |
| Switching from Cu-IUD | CHC can be started at any time of the cycle | None if up to and including day 5 (IUD can be removed at that time) If starting CHC after day 5, required for 7 days (9 days for Qlaira®) and defer removal of IUD if unprotected intercourse in the previous 7 days |
| Switching from barrier method |
CHC can be started at any time. At any other time if it is reasonably certain she is not pregnant |
Non if up to and including day 5. If starting CHC after day 5, required For 7 days 9 days for Qlaira® |
*Please note if changing from one CHC to an alternative CHC and have had a 7 day hormone free interval, additional precautions and need for EC maybe required.