Quick update on contraception By Miss Rahat Khan Consultant Obstetrician and Gynaecologist

UK Medical Eligibility Criteria 2016 table for categories

UK Medical Eligibility criteria 2016- Changes published by Faculty of Sexual and Reproductive Healthcare No split categories Lay out of summary prioritises Long acting reversible contraceptives (LARCS) Conditions added and removed Added Removed Bariatric surgery Schistosomiasis (WHOMEC) cardiomyopathy Malaria (WHOMEC) Post-transplant Raynaud’s phenomenon (risk relates to underlying disease) Cardiac arrhythmias Drug interactions (refer to data resources) Rheumatoid arthritis Barrier methods, fertility awareness and sterilisation removed (use FSRH methd –specific guidelines) Positive antiphospholipid antibodies

UKMEC 2016- changes Postpartum - Fully/near fully breastfeeding from 6/52 to 6/12 goes from 3 to 2 for CHC -Fitting of an IUCD or IUS within 48 hours now category 1 Bariatric surgery -All methods category 1 with regard to the surgery itself - Normal BMI limits apply for CHC Transplant surgery - Uncomplicated= category 2 - Complicated=CHC and insertion of IUCD category 3 CVS risk factors and CHC - Dyslipidaemia changes from 2/3 to 2 - Multple risk factors for CVS changes from 3/4 to 3 - Smokers over 35 unchanged > 15 = 4 <15 /within 1 year of stopping= 3 Stopped for more than a year= 2

UKMEC update –March 2017 Change of UKMEC category for use of progestogen-only injectable contraception by women at high risk of HIV infection from UKMEC 1 to UKMEC 2. The WHO GDG concluded that overall the available evidence (13 observational studies) continues to indicate an association between use of progestogen-only injectable contraceptives and an increased risk of acquiring HIV, amongst women at high risk.

REFERENCES FSRH contraception after pregnancy January 2017 FSRH UKMEC for contraceptive use July 2016 THANK YOU