๐งญ When to consider
Contraception is relevant to anyone of reproductive age who wishes to avoid pregnancy.
In primary care, match an effective method to the person's preferences while screening for medical eligibility. Safety is judged using the Faculty of Sexual and Reproductive Healthcare (FSRH) UK Medical Eligibility Criteria (UKMEC).
Note that the FSRH was renamed the College of Sexual & Reproductive Healthcare (CoSRH) in 2025, and that UKMEC 2025 now supersedes the 2016 edition.
Two principles run through every consultation:
โข UKMEC relates to safety, not effectiveness โ it tells you what is safe, not what is best, and it does not account for drug interactions.
โข The most effective methods are the long-acting reversible contraceptives (LARC) โ the implant, the intrauterine system (IUS) and the copper coil โ because they remove the risk of user error.
| UKMEC category | Meaning | In practice |
|---|---|---|
| 1 | No restriction | Use the method freely |
| 2 | Advantages generally outweigh risks | โข Generally use โข Some follow-up may be needed |
| 3 | Risks usually outweigh advantages | Not usually recommended โ needs expert judgement or referral |
| 4 | Unacceptable health risk | Do not use |
Multiple category 2 conditions relating to the same risk, or more than one category 3, may together make a method unsuitable โ apply clinical judgement.
Source: FSRH UKMEC 2025
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