Clinical Education Forum Recording: Contraception Update

SHINE SA, November 2018

Clinicians:  SHINE SA is pleased to present the following Clinical Forum by Dr Amy Moten on the topic of Contraception.

This recording is available free of charge, and access is limited to three months only.

This forum covers emergency contraception and new formulations of the Pill.

3 Category 2 RACGP Points can be awarded on completion of the forum.

Recording length: 1 hour 18 minutes

SHINE SA Media Release: Response to the call to ban Diane-35

SHINE SA, issued 13th December 2017

SHINE SA believes everyone should have access to contraceptive choices, and that decisions about contraception are best made in conjunction with a healthcare professional.

Cyproterone acetate pills, commonly known as Diane-35 appear to be associated with a higher risk of deep venous thrombosis (DVT) than levonorgestrel (LNG) containing pills, although the overall risk is still very low for most people.

For those who choose combined pills, we recommend as first choice the pills with lowest risk: those containing levonorgestrel or norethisterone as their progesterone. However, the other progestogen choices, which all carry a small increased risk of DVT compared to LNG, may be utilised if specific added benefits are required. Health professionals can review over time the experience individuals may have with their contraceptive choice.

Cyproterone acetate can be used as treatment for signs of androgenisation in people such as severe acne (involving inflammation or nodularity, or risk of scarring) where prolonged oral antibiotics or local treatment alone have not been successful, or idiopathic hirsutism of mild to moderate degree. The oral contraceptive pill containing cyproterone acetate can also provide effective oral contraception in this patient group.
People who have concerns should seek advice from their doctor before stopping their oral contraceptive pill.

Download Media release (PDF): Response to the call to ban Diane-35 SHINE SA Diane35_13 Dec 17_FS

 

SHINE SA Media Release: Response to ABC report on Long Acting Reversible Contraception (LARCs)

SHINE SA, Issued: 13 December 2017

SHINE SA believes that decisions about contraception should be made in conjunction with a health care professional and that everyone should have access to accurate and unbiased information to enable appropriate informed contraceptive choice.

LARCs (Long Acting Reversible Contraception) including the levonorgestrel IUD1 (Mirena) and the subdermal implant (Implanon NXT) are the most effective reversible methods of contraception available. They have the additional advantage of being long lasting, convenient to use and generally well regarded by most users. LARC method failure rates rival that of tubal sterilization at <1% and unintended pregnancy rates are lower than those reported for contraceptive pill users.

Like all progestogen only contraceptive methods, LARCs may result in a change of bleeding pattern which may include no bleeding, frequent or prolonged bleeding. Users of the levonorgestrel IUD most commonly experience a reduction in bleeding over time and it is used as a treatment for Heavy Menstrual Bleeding for this reason. Only 1 in 5 users of the contraceptive implant have an increase in bleeding that persists beyond the first few months.

LARC use, and in particular the subdermal implant, is not known to be associated with pelvic inflammatory disease (PID) which is an infection of the upper part of the female reproductive system namely the uterus, fallopian tubes, and ovaries. PID is a known side effect of IUD insertion but occurs in less than 1 in 300 people. The risk of PID is only increased for the first 3 weeks after insertion, after which it returns to the previous background risk. Users of IUDs are encourage to return at any sign of infection and when treated promptly with antibiotics are unlikely to experience any long term complications.

Mirena IUD effective for seven years: new study

Dr Jennifer Gunter, September 10 2016

The Mirena intrauterine system (IUS), the IUD with the hormone levonorgestrel, is a highly effective method of contraception currently approved for five years. Some data suggests that it probably good for six years, but a new study tells us with a good degree of confidence that the Mirena is safe and effective for seven years. 

The study was funded by UNDP/ UNFPA/WHO/World Bank Special Programme of Research and published in the journal Contraception.