TAILIEUCHUNG - Faculty of Sexual & Reproductive Healthcare Clinical Guidance: Quick Starting Contraception

Co-cyprindiol (ethinylestradiol and cyproterone acetate; Dianette®, Clairette®) is indicated primarily for acne or hirsutism but it is also contraceptive and concerns have been raised about fetal exposure to cyproterone acetate. The SPC for Dianette29 advises that pregnancy must be excluded before treatment is begun, and states that animal studies have revealed that feminisation of male fetuses may occur if cyproterone acetate is administered during the phase of embryogenesis at which differentiation of the external genitalia occurs. Although the results of these tests are not necessarily relevant to man, the possibility must be considered that administration of Dianette to women after the 45th day of pregnancy could cause feminisation. | -------FACULTY-------- -----OF SEXUAL------ REPRODUCTIVE HEALTHCARE Faculty of Sexual Reproductive Healthcare Clinical Guidance Quick Starting Contraception Clinical Effectiveness Unit September 2010 ISSN 1755-103X ABBREVIATIONS USED CEU Clinical Effectiveness Unit CHC combined hormonal contraception CI confidence interval COC combined oral contraception Cu-IUD copper-bearing intrauterine device CVR combined vaginal ring DMPA depot medroxyprogesterone acetate EC emergency contraception FSRH Faculty of Sexual and Reproductive Healthcare GMC General Medical Council LNG-IUS levonorgestrel-releasing intrauterine system NMC Nursing and Midwifery Council OR odds ratio PGD patient group direction POEC progestogen-only emergency contraception POP progestogen-only pill SPC Summary of Product Characteristics UPA ulipristal acetate UPSI unprotected sexual intercourse GRADING OF RECOMMENDATIONS Evidence based on randomised controlled trials Evidence based on other robust experimental or observational studies Evidence is limited but the advice relies on expert opinion and has the endorsement of respected authorities Good Practice Point where no evidence exists but where best practice is based on the clinical experience of the multidisciplinary group Published by the Faculty of Sexual and Reproductive Healthcare Registered in England No. 2804213 and Registered Charity No. 1019969 First published in 2010 Copyright Faculty of Sexual and Reproductive Healthcare 2010 Permission granted to reproduce for personal and educational use only. Commercial copying hiring and lending are prohibited. CEU GUIDANCE CONTENTS Abbreviations Used IFC Grading of Recommendations IFC Summary of Key Recommendations ii Decision-making Algorithm for Quick Starting Contraception iii Summary of Additional Contraceptive Requirements When Starting Contraception iv 1 Purpose and Scope 1 2 Background 1 3 What is Meant by Quick Starting and Bridging Contraception 1 4 What are the Potential Benefits of Quick .

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