Combined oral contraception: nomegestrol/estradiol (Zoely)

Introduction

The combined oral contraceptive pill is one of the most commonly used contraceptive methods in the UK. Most combined oral contraceptives used in the UK are fixed dose (monophasic) pills containing ethinylestradiol (a synthetic oestrogen) in combination with a progestogen. Variable dose (phasic) combined oral contraceptives are also available. Most combined oral contraceptives contain 21 active pills; the first 7 pills inhibit ovulation and the remaining 14 pills maintain anovulation. Traditionally, women have then either had 7 pill-free days or taken 7 placebo tablets before starting the next packet of pills. During this time, most women will have a withdrawal bleed, which is caused by the withdrawal of hormones rather than physiological menstruation.

The Faculty of Sexual & Reproductive Healthcare clinical guidance on combined hormonal contraception (2011), which has been accredited by NICE, advises that all combined hormonal contraceptives (combined oral contraceptive pills, the combined transdermal patch and the combined vaginal ring) are similarly effective. Healthcare professionals prescribing combined hormonal contraceptives should be guided by the woman's personal preference, risk of venous thromboembolism, any contraindications, possible non-contraceptive benefits and experience with other contraceptive formulations. See the Faculty of Sexual & Reproductive Healthcare's guidance for more information.