FPA patient information booklet updates based on latest UKMEC guidance

Progestogen-only pill (POP): The FPA guide

Now updated, clinically reviewed, user tested and in line with UKMEC.

New 2026 guide now in stock in the FPA shop.

Covering UKMEC in the new Progestogen-only pill guide:

This guide was reviewed between Dec 2025 and Jan 2026. The guide was not particularly affected by the new UKMEC as relevant information added to the UKMEC was already available in the 2022 (amended 2023) CoSRH POP guidance.

However some important new information has been added to the FPA guide, including:

• Information on how the POP is affected by some GLP-1 agonists such as tirzepatide
• Information on other medicines that may interact with POP to make it less effective
• Information on the small increased risk of a meningioma with the desogestrel POP
• Updated typical effectiveness rates based on current research
• Wider availability of oral contraception – including free emergency contraception – from pharmacies

There have also been further small clarifications and wording updates throughout.

• New evidence on the risk of blood clots (VTE) in combined hormonal contraception users. Anyone with more than one risk factor for VTE should not use the combined pill. This is a UKMEC 4 which means the method presents an unacceptable risk in this situation.

• In addition, anyone with an immediate family member who has had a blood clot should not usually use the pill. This is UKMEC 3 which means the risks usually outweigh the benefits. It’s a change from previous guidance. The UKMEC 3 previously only applied if the family member was aged under 45 at the time of the blood clot.

• Vaping and smoking: There is a clarification that due to limited evidence, vaping should be treated in a similar way to smoking. The UKMEC says that “given the unknown long term cardiovascular risks” alternatives to combined hormonal contraception “should be prioritised.”

• Major surgery: This is a UKMEC 4, with the UKMEC saying that any combined hormonal contraception “should preferably be discontinued (and adequate alternative contraception arrangements made) 4 weeks before major elective surgery (>30 minutes duration) and all surgery on the legs or surgery which involves prolonged immobilisation of a lower limb.” The method can “normally be restarted at least 2 weeks after full mobilisation.” There is also advice on what to do if discontinuation is not possible.

• Chronic kidney disease (CKD): Combined hormonal contraception is a UKMEC 4 for people with CKD. This is due to an increased risk of thromboembolic events.

• Complicated organ transplant: This a new category and combined hormonal contraception is a UKMEC 3.

The UKMEC only covers the safety of contraception methods. We have also added important new information to the guide that is not covered by the UKMEC:

• Information on how the combined pill is affected by some GLP-1 agonists such as tirzepatide
• Information on other medicines that may interact with the combined pill to make it less effective
• Information on the small increased risk of a meningioma with combined pills that contain the progestogen desogestrel
• Wider availability of oral contraception – including free emergency contraception – from pharmacies

There have also been some further small clarifications and wording updates throughout.

Contraceptive Injections: The FPA guide

The January 2021 edition of the guide can still be used until the 2026 edition is available but please use it in conjunction with the new UKMEC guidance.

The current FPA guide does not cover:

Contraception After a Baby: The FPA guide

The April 2024 edition of the guide can still be used until the 2026 edition is available but please use it in conjunction with the new UKMEC guidance.

The current FPA guide does not cover:

• When to start the injection: It’s now recommended that anyone with any additional risk factors for VTE waits until 6 weeks after giving birth before starting the injection. Those without additional risk factors can still start the injection any time after the birth.

We do not currently have a planned reprint date for this guide, so please continue to use the existing guide being mindful of the new recommendation so you can counsel patients accordingly.