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Combined hormonal contraception (CHC): COC, patch, ring

A detailed Australian summary of combined hormonal contraception (chc): coc, patch, ring, with source-attributed priorities, a practical workflow, safety escalation and state or territory implementation boundaries.

JurisdictionAustralia
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Australia
This is an iatroX educational summary of named Australia sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. Apply current TGA product information, PBS restrictions, state or territory law, local referral criteria, formulary and antimicrobial policy. A national recommendation does not create uniform service access.

Scope

Confirm pregnancy exclusion, reproductive goals, blood pressure, smoking, migraine aura, thromboembolism, cardiovascular, liver and breast-cancer history before prescribing. Explain pill, patch and ring effectiveness, adherence demands, bleeding patterns and non-contraceptive benefits and compare them with long-acting reversible options. This summary is limited to the population, decisions and escalation boundaries stated in the named source.
sources for this section:RANZCOG contraception

The Bottom Line

  • Confirm pregnancy exclusion, reproductive goals, blood pressure, smoking, migraine aura, thromboembolism, cardiovascular, liver and breast-cancer history before prescribing.
  • Explain pill, patch and ring effectiveness, adherence demands, bleeding patterns and non-contraceptive benefits and compare them with long-acting reversible options.
  • Migraine with aura is a major arterial-risk contraindication to oestrogen-containing contraception under Australian eligibility criteria.
  • Use Australian medical eligibility criteria and choose oestrogen and progestogen exposure with venous and arterial risk in mind.
sources for this section:RANZCOG contraception

Practical clinical workflow

1

Topic-specific assessment action

Confirm pregnancy exclusion, reproductive goals, blood pressure, smoking, migraine aura, thromboembolism, cardiovascular, liver and breast-cancer history before prescribing.
2

Topic-specific diagnostic action

Use Australian medical eligibility criteria and choose oestrogen and progestogen exposure with venous and arterial risk in mind.
3

Topic-specific management action

Give exact missed-method, vomiting, interaction and enzyme-inducer advice from the Australian handbook and plan review of pressure and adverse effects.
4

Topic-specific follow-through

Blood pressure must be measured before initiation and repeated because uncontrolled hypertension can make combined contraception unsafe.
sources for this section:RANZCOG contraception

Safety boundaries and escalation

  • New unilateral leg swelling, chest pain, dyspnoea, focal neurology, severe new headache or jaundice requires immediate assessment; stop the combined method until a clinician has assessed whether it is safe to continue.
  • Use a lower-risk alternative during the postpartum venous-thromboembolism window and consider breastfeeding and caesarean risk.
sources for this section:RANZCOG contraception

Implementation

The named source is national or binational guidance used in Australia, but referral access, public-health directions, formularies and funded services can still differ by state, territory and health service. Check current TGA product information for medicines. Offer culturally safe care and use the NACCHO鈥揜ACGP National Guide where Aboriginal and Torres Strait Islander preventive or chronic-care recommendations differ.
sources for this section:RANZCOG contraception

Clinical use boundary

This independently written summary is not an official guideline. Check the linked source version, current TGA-approved product information where medicines are involved, and the applicable state, territory and local pathway at the point of care.

sources for this section:RANZCOG contraception

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Royal Australian and New Zealand College of Obstetricians and GynaecologistsContraception (C-Gyn 3)C-Gyn 3 路 Version 7.2, September 2024; review due March 2029 路 accessed 2026-08-20
    view source
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