Non-oral hormonal contraception

SummaryThis review will consider the non-oral hormonal contraceptive methods—combined injectables, intramuscular and subcutaneous progestogen-only injectables, progestogen implants, the Levonorgestrel intrauterine system, transdermal patches and the, as yet unavailable, vaginal Nuvaring. The long-acting methods used as implants, injectables or as part of an intrauterine system are highly effective forgettable contraceptive methods and are likely to have a significant impact on the reduction of unintended pregnancy rates. They avoid the hepatic first pass metabolism and gastrointestinal interference with absorption of hormonal components, thus allowing lower doses to be used, which may reduce the incidence of side effects and risks.