Non-hormonal contraception

The second edition of this article discussed developments in intrauterine contraception and barriers methods. For this edition we have re-titled the article ‘non-hormonal methods’ and thus omitted the discussion on the intrauterine system (IUS), Mirena. There are two reasons for this. First, patients requiring contraception may specifically request a ‘non-hormonal method’. Second, Mirena, although technically an intrauterine device (IUD), demands other considerations – given its hormonal content. Unlike the copper IUD, the IUS has other licensed indications besides contraception – including its role in first-line management of heavy menstrual bleeding, as recommended by the National Institute of Clinical Excellence (NICE) in January 2007.We also highlight two recent pieces of guidance: the NICE recommendations on long-acting reversible contraception (LARC) published in November 2005; and the UK Medical Eligibility Criteria (UK MEC) published in 2006 by the Clinical Effectiveness Unit (CEU) of the Faculty of Family Planning and Reproductive Health Care (FFPRHC).