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.
- 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.