What is the recommended follow-up for patients starting combined hormonal contraception to monitor for adverse effects?

Recommended follow-up protocol for patients initiating combined hormonal contraception (CHC):

• Patients should be advised to return for a follow-up appointment within 3 months of starting CHC to monitor for adverse effects and ensure correct use of the method.
• During this follow-up, healthcare professionals should address any concerns related to possible risks and adverse effects such as weight gain, mood changes, altered bleeding patterns, dysmenorrhoea, loss of bone mineral density, venous thromboembolism, return of fertility, and cancer risk.
• Patients should be informed to seek medical advice at any time if they develop problems with the contraception before the scheduled follow-up.
• Testing for sexually transmitted infections (STIs) is recommended 2 weeks and again 12 weeks after any unprotected sexual intercourse, which may coincide with follow-up visits.
• For CHC users, tailored regimens can be considered, but safety monitoring remains similar to standard regimens.

These recommendations are based on the Faculty of Sexual and Reproductive Healthcare (FSRH) guidelines and NICE Clinical Knowledge Summaries (CKS) on contraception.

Summary: Follow-up within 3 months after initiation, with earlier review if adverse effects occur, focusing on monitoring for common side effects and ensuring correct use.

References: ¹, ²