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Non-contraceptive benefits of hormonal contraception

02 August 2019
Volume 1 · Issue 8


Beyond their primary role of preventing pregnancy, hormonal contraceptives provide a number of non-contraceptive benefits including a reduction in menstrual pain and bleeding, improvement in acne and a decrease in the lifetime risk of cancer of the ovaries and endometrium. They are also widely used in the management of a number of gynaecological conditions including endometriosis, premenstrual syndrome and polycystic ovary syndrome. Although the risks may outweigh the benefits when a method is used solely for contraception, the risk-benefit profile may change when it is also used for a medical indication. Potential non-contraceptive benefits should be discussed with all women when considering the most appropriate form of contraception to suit their needs.

Beyond their primary role of preventing pregnancy, hormonal contraceptives provide a number of non-contraceptive benefits (Table 1), the most well-established of which are described in this article. Some of these benefits may be key factors affecting a woman's contraceptive choice, such as effect on menstrual bleeding; while others may be more secondary advantages, such as reduction in the lifetime risk of certain cancers.

Hormonal contraceptives also have an important role in the management of many gynaecological conditions, some of which may be outside standard product licenses, but are supported by clinical guidelines. Where a drug is used outside its product license, the prescriber should discuss the proposed treatment fully with the patient and be satisfied that there is sufficient clinical evidence to support its use. In the case of contraception, the Faculty of Sexual and Reproductive Healthcare (FSRH) produce evidence-based guidance on contraceptive prescribing in the UK, including clear indications for off-label use. The UK Medical Eligibility Criteria (UKMEC) summarises the suitability of each method for contraceptive purposes only. Although the risks may outweigh the benefits when a method is used solely for contraception, the risk-benefit profile may change when it is used for a medical indication, and expert clinical judgment should always be sought.

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