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Switching from IUCD (IUC) to combined hormonal contraceptive (CHC)

Authoring team

 

IUC method switching to

Contraceptive method switching from

Timing of IUC insertion

Need for additional precautions

Additional information

Cu-IUD

All methods of contraception

Cu-IUD can be inserted at any time if another method of contraception has been used consistently and correctly and it is reasonably certain that the woman is not pregnant or at risk of pregnancy (except in those circumstances that would qualify for use as an EC)

No additional precautions required

Ideally if switching from an LNG-IUS to a Cu-IUD additional contraceptive precautions are advised in the 7 days before changing in case the new method cannot be inserted

LNG-IUS

CHC

Week 2 or 3 of CHC cycle or Day 1 of the hormone-free interval

No additional precautions required, providing CHC used correctly for 7 days prior to insertion

There is evidence to suggest that taking hormonally active pills for 7 consecutive days prevents ovulation

LNG-IUS

CHC

After Day 1 of the hormone free interval or in Week 1 of CHC cycle

Continue CHC or use other additional contraception for 7 days

Advice for switching during the hormone-free interval may be overcautious but there is a theoretical risk that ovulation may occur as early as Day 10 after stopping CHC, before the LNG-IUS is fully effective

LNG-IUS

POP

At any time

Yes, continue POP or use other additional contraception for 7 days

LNG-IUS

Progestogen-only implant

Up to 3 years post-insertion

No

Progestogen-only implant

From 3 years post-insertion

Yes (7 days)

If it is reasonably certain the woman is not pregnant or at risk of pregnancy

LNG-IUS

Progestogen-only injectable

<=14 weeks post-IM or SC injection

No

Progestogen-only injectable

>14 weeks since last IM or SC injection

Yes (7 days)

If it is reasonably certain the woman is not pregnant or at risk of pregnancy

LNG-IUS

Barrier methods

Days 1-7 of the menstrual cycle

No

Barrier methods

After Day 7 of the menstrual cycle

Yes, 7 days

If it is reasonably certain the woman is not pregnant or at risk of pregnancy

LNG-IUS

Cu-IUD

Any time

Yes (7 days)

If sex has occurred in the last 7 days advise to leave Cu-IUD for a further 7 days from that episode and use extra precautions before change to LNG-IUS

Reference:

  • FSRH Guidance (April 2015) Intrauterine Contraception

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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