Combined Hormonal Contraception and Surgery

Guidance from the FSRH UKMEC 2016 states that for major and minor surgery:

CHC (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. CHC should normally be recommenced at least 2 weeks after full mobilisation

POC (progesterone-only contraception) may be offered as an alternative and the CHC restarted after mobilisation, as above. When discontinuation of CHC is not possible (e.g. after trauma or if a patient admitted for an elective procedure is still using CHC), thromboprophylaxis (with low molecular weight heparin and graduated compression hosiery) is advised. These recommendations do not apply to minor surgery with short duration of anaesthesia (e.g. laparoscopic sterilisation or tooth extraction), or to women using oestrogen free hormonal contraception

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