Start times and switching from other contaceptives

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 criteria for reasonable exclusion of pregnancy
For 7 days
9 days for Qlaira
Women with
secondary amenorrhoea
At any time, if it is reasonably
certain that she is not pregnantsee criteria for reasonable exclusion of pregnancy
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 IUS 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 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.

Editorial Information

Last reviewed: 31/05/2022

Next review date: 31/05/2024

Author(s): West of Scotland Managed Clinical Network for Sexual Health Clinical Guidelines Group.

Version: 7.1

Approved By: West of Scotland Managed Clinical Network for Sexual Health