Starting progestogen-only injectable contraception post other form of contraception

Situation

Starting

Additional contraceptive protection required?

Additional information

Switching from combined hormonal contraception (CHC) (if taken correctly)

Day 1-2 of the hormone free interval (HFI)

No

Switching from CHC (if taken correctly)

Day 3-7 of HFI OR week 1 following the HFI

Yes (7 days). If unprotected sexual intercourse (UPSI) has occurred after Day 3 of the HFI, advise continuing the CHC method for at least 7 days

When switching after a 7-day HFI there are no data to confirm that suppression of ovulation is maintained

Switching from CHC (if taken correctly)

Week 2-3 of pill/ring/patch

No, providing the CHC method has been used consistently and correctly for 7 consecutive days before switchin

There is evidence to suggest that taking hormonally active pills for 7 consecutive days prevents ovulation. Therefore as long as there have been 7 days of CHC use, 7 hormone-free days can occur without any effect on contraceptive efficacy

Switching from traditional POP (if taken correctly) OR LNG-IUS

Any time

Yes (7 days) If UPSI in last 7 days, retain LNG IUS for 7 days after starting injectable

The continuing method provides contraceptive cover while the effects of the injectable are established

Switching from desogestrel POP (if taken correctly) OR progestogen-only implant (<=3 years since implant insertion)

Any time

No

>3 years since implant insertion

Any time

Yes (7 days)

If there has been a risk of pregnancy consider the need for emergency contraception (EC) and a pregnancy test (PT) no sooner than 3 weeks after the most recent incidence of UPSI

Switching from Cu-IUD

Day 1-5 of menstrual cycle

No

Switching from Cu-IUD

Any other time

Yes (7 days). If UPSI in last 7 days, retain Cu-IUD for 7 days