- Described as any oral hormonal preparation containing an oestrogen in conjunction with a progestogen.
- In current practice, low dose COCs contain 20 – 35 micrograms (mcg) of ethinylestradiol (EE) in combination with a progestogen.
- Progestogens include norethisterone, levonorgestrel, desogestrel, gestodene, norgestimate and drospirenone.
- The primary mode of action of this type of preparation is to prevent ovulation. These pills are packed in 21 day packs but are also available as every-day packs with placebo tablets to aid concordance with the method.
- Extended and tailored regimens can be offered (with the client made aware of off license use)
- There are 2 products containing oestradiol (Zoely® with oestradiol hemihydrate combined with nomegestrol in a 28 day pack, and Qlaira® with oestradiol valerate combined with dienogest in a 28 day pack), but neither are approved by SMC for contraceptive use within Scotland
Types of combined hormonal contraception
Warning
- Currently in the UK there is one transdermal contraceptive patch which releases 33.9 micrograms ethinylestradiol and 203 micrograms norelgestromin per 24 hours (Evra®).
- One patch to be applied once weekly for three weeks, followed by a 7 day patch free interval
- Extended and tailored regimens can also be discussed
- The combined vaginal ring (Nuvaring® or Syreniring® ) consists of ethylene vinyl acetate (latex-free) and releases 15 micrograms ethinylestradiol and 120 micrograms etonogestrel daily. One ring should be inserted vaginally for 3 weeks of use per cycle.
- This should then be removed and a new ring inserted after a 7-day ring-free break.
- Nuvaring® must be kept refrigerated prior to dispensing to the client. Syreniring® does not require refrigeration. After removal from the fridge, Nuvaring® can be stored at room temperature and used within 4 months. Women should therefore only be supplied with up to 3 Nuvaring® rings at a time. Syreniring® can be supplied as a years supply
- Extended and tailored regimens can also be discussed