hormone replacement therapy (HRT) and contraception

Last edited 02/2020 and last reviewed 10/2020

Hormone Replacement Therapy and Contraception

  • women using hormone replacement therapy (HRT) should be advised not to rely on this for contraception

  • women may use a Mirena 52 mg LNG-IUS with estrogen for up to 5 years for endometrial protection as part of an HRT regimen. Women using Mirena for this purpose must have the device changed every 5 years

  • at the present time, POP (progestogen only pill), IMP (progestogen only implant) and DMPA (depot medroxyprogesterone acetate) are not licensed for and cannot be recommended as endometrial protection with estrogen-only HRT (2)

  • all progestogen-only methods of contraception are safe to use as contraception alongside sequential HRT

  • CHC (combined hormonal contraception) can be used in eligible women under 50 as an alternative to HRT for relief of menopausal symptoms and prevention of loss of BMD

Contraceptive options in conjunction with hormone replacement therapy (HRT)


  1. FFPRHC Guidance (January 2005) Contraception for women aged over 40 years Journal of Family Planning and Reproductive Health Care 2005; 31(1): 51-64
  2. FSRH (September 2019). Contraception for Women Aged Over 40 Years.