SRHA Reference Group Statements

Statements from the Clinical Reference Group of the Medical Advisory Committee of Sexual and Reproductive Health Australia Alliance

The Medical Advisory Committee of Sexual and Reproductive Health Australia (SRHA) (formerly known as the Family Planning Alliance Australia) has released a collection of clinical statements on various contraceptive topics for health practitioners. The SRHA Medical Advisory Committee comprises senior medical educators, senior medical officers and medical directors of the member Sexual and Reproductive Health Australia organisations. The committee reviews current clinical practice and provides evidence and consensus-based recommendations for use by health practitioners. The statements cover new and emerging contraception issues and guide areas where evidence is lacking.

Progestogen-only Methods

• Progestogen-only contraception and breast cancer

LARC

• Extended use of long-acting reversible contraceptive methods

IUDs

• Malposition and perforation of IUDs
• Pregnancy with an IUD in situ
• Menstrual cups and IUDs
• IUD and cervical cleansing
• The levonorgestrel IUD as Emergency Contraception

Etonogestrel implants (Implanon NXT®)

• Obesity and Implanon NXT®
• Non-sterile gloves to insert Implanon NXT®

Combined Hormonal Contraception

• Switching from a combined hormonal method to a progestogen-only method
• Decreasing bleeds in users of the pill and vaginal ring

Using the combined pill and vaginal ring to skip or delay bleeding is popular. Tailored pill-taking involves taking the combined pill or vaginal ring (changed every 3 weeks) continuously until 4 or more days of unscheduled bleeding occurs and then having a 4-day break.

Progestogen Only Oral Contraception

The Drospirenone Only Pill: Starting and Missed Pill Advice

Emergency Contraception

• Ulipristal (Ella 1®) and Breastfeeding
• Ulipristal (Ella 1®) and hormonal contraception.

Rapid initiation of hormonal contraception decreases the efficacy of ulipristal in preventing pregnancy. If a user would like to start hormonal contraception, it will not affect the efficacy of ulipristal if it is delayed for 5 days after taking ulipristal. The efficacy of ulipristal might be decreased in current users of hormonal contraception.

• Oral emergency contraception and further episodes of unprotected sex.

The dose should be repeated if a person has a further episode of unprotected sex after taking oral emergency contraception.

Drug interactions with hormonal contraceptives

• Griseofulvin
• Topiramate at any dose
• Vitex agnus-castus

General contraception issues

• Vaping and hormonal contraception
• Oral hormonal contraceptives and vomiting

Terms and conditions

These resources provide general information only. The suitability of such general information varies from person to person, depending on individual circumstances.

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If you are not a clinician then you should seek specific medical or legal advice on your individual circumstances.