Feature Article

Hormonal contraception: what’s new?

Feature Article

Hormonal contraception: what’s new?

Deborah Bateson, Kathleen McNamee

Figures

© photographee.eu/ stock.adobe.com model used for illustrative purposes only
© photographee.eu/ stock.adobe.com model used for illustrative purposes only

Abstract

Changes in the past 12 months include the PBS listing of a new low-dose levonorgestrel intrauterine device and revised recommendations on placement of the etonogestrel implant, tailored use of combined hormonal contraception, emergency contraception, contraception and vaping, and concurrent use of liver enzyme-inducing medications.

Key Points

  • A low-dose five-year 19.5mg levonorgestrel intrauterine device (LNG-IUD) with a slightly smaller frame than the 52mg LNG-IUD is available on the PBS, offering additional choice of contraception, including for nulliparous and younger people.
  • The 52mg, but not the 19.5mg, LNG-IUD inserted at age 45 years or older can be used until menopause is confirmed or age 55 years (off-label extended use).
  • The approved placement site for the etonogestrel implant is now over the triceps, about 8 to 10cm from the medial epicondyle and 3 to 5cm below the sulcus, to avoid the risk of damage to large vessels and nerves.
  • Extended and flexible use of combined hormonal contraception avoids regular withdrawal bleeding and offers potential benefits in relation to effectiveness and troublesome side effects.
  • Australian practitioners need to be aware of contraception methods available in other countries, including the two-rod levonorgestrel implant used in New Zealand.