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The Lowdown’s book references

Intro

  1.  Moreau C., Cleland K., Trussell J., ‘Contraceptive discontinuation attributed to method dissatisfaction in the United States’, Contraception 2007 Oct;76(4):267–72. 
  2. Johnson S., Pion C., Jennings V., ‘Current methods and attitudes of women towards contraception in Europe and America’, Reprod Health 2013 Feb 5;10:7.
  3. Chamberlain S. G. et al., ‘Reboot contraceptive research – it’s been stuck for decades’, Nature 2020 Nov; 587.
  4. Kresge N., Koons, C., ‘Better birth control exists, but Big Pharma isn’t interested’, Bloomberg, 2019. https://www.bloomberg.com/news/articles/2019-08-08/better-birth-control-exists-but-big-pharma-isn-t-interested
  5. Survey of 120 users of The Lowdown, May 2020.
  6. Stacey L., ‘How the Faculty of Sexual and Reproductive Healthcare was born’, Faculty of Sexual and Reproductive Healthcare website, Nov 2018.
  7. British Association of Sexual Health and HIV (BASHH) and the British HIV Association (BHIVA), BHIVA website, Sep 2018.
  8. ‘Contraceptive deserts’, Power to Decide website. https://powertodecide.org/what-we-do/contraceptive-deserts. Accessed 12 Aug 2024.
  9. Liu K. A., Mager N. A., ‘Women’s involvement in clinical trials: historical perspective and future implications’, Pharmacy Practice 2016 Jan–Mar;14(1):708.

Chapter 1

  1. UK Clinical Research collaboration, UK Health Research Analysis 2022. Published by the Medical Research Council, part of UK Research and Innovation. https://hrcsonline.net/wp-content/uploads/2024/04/UK_Health_Research_Analysis_Report_2022_web_v1-1-postpub.pdf 
  2. Public Health England press release, ‘Survey reveals women experience severe reproductive health issues’. June 2018.  https://www.gov.uk/government/news/survey-reveals-women-experience-severe-reproductive-health-issues Nicola Slawson, ‘Women have been woefully neglected: does medical science have a gender problem?’ Guardian, 18 Dec 2018.  https://www.theguardian.com/education/2019/dec/18/women-have-been-woefully-neglected-does-medical-science-have-a-gender-problem
  3. Rahmioglu N. et al., ‘The genetic basis of endometriosis and comorbidity with other pain and inflammatory conditions’, Nat Genet 2023 Mar;55(3):423–36.     
  4. Chavez-MacGregor M., van Gils C. H., van der Schouw Y. T., Monninkhof E., van Noord P. A., Peeters P. H., ‘Lifetime cumulative number of menstrual cycles and serum sex hormone levels in postmenopausal women’, Breast Cancer Res Treat 2008 Mar;108(1):101–12.           
  5. Scottish Government, NHS Inform. Periods. May 2023. https://www.nhsinform.scot/periods
  6. Pearlstein T., ‘Prevalence, impact on morbidity, and disease burden’, in P. M. O’Brien, A. J. Rapkin, P. J. Schmidt (eds.), The Premenstrual Syndromes: PMS and PMDD (Boca Raton, FL: CRC Press, 2007), pp. 37–47.
  7. Alexandra Jones, ‘Spain’s paid menstrual leave hits unsympathetic employers where it hurts – in their bottom line’. London Evening Standard, 13 June 2023. https://www.standard.co.uk/lifestyle/spain-period-menstrual-leave-british-economy-b1087490.html
  8. Bofill Rodriguez M., Lethaby A., Farquhar C., ‘Non-steroidal anti-inflammatory drugs for heavy menstrual bleeding’, Cochrane Database Syst Rev. 2019 Sep 19;9(9):CD000400. Roy S. N., Bhattacharya S., ‘Benefits and risks of pharmacological agents used for the treatment of menorrhagia’, Drug Safety 2004;27(2):75–90. 
  9. Prior J. C., Naess M., Langhammer A., Forsmo S., ‘Ovulation prevalence in women with spontaneous normal-length menstrual cycles – a population-based cohort from HUNT3, Norway’, PLoS One 2015 Aug 20;10(8):e0134473.      
  10. Prior J. C., ‘Adaptive, reversible, hypothalamic reproductive suppression: more than functional hypothalamic amenorrhea’, Front Endocrinol (Lausanne) 2022 Oct 19;13:893889. 
  11. de Ziegler D., Fanchin R., ‘Progesterone and progestins: applications in gynecology’, Steroids 2000;65(10–11):671–9. Kuhl H., ‘Pharmacology of estrogens and progestogens: influence of different routes of administration’, Climacteric. 2005;8 Suppl 1:3–63.      
  12. Apgar B. S., Greenberg G., ‘Using progestins in clinical practice’, Amer Fam Phys 2000;62(8):1839–50.  Available from:  https://www.aafp.org/afp/2000/1015/p1839.html      

Chapter 2

  1. United Nations Department of Economic and Social Affairs. World Family Planning 2022, Meeting the changing needs for family planning: Contraceptive use by age and method View pdf
  2. Blakemore, ‘The first birth control pill used Puerto Rican women as guinea pigs’. History. August 2023. https://www.history.com/news/birth-control-pill-history-puerto-rico-enovid
  3. American Experience, ‘The Puerto Rico pill trial’. https://www.pbs.org/wgbh/americanexperience/features/pill-puerto-rico-pill-trials/ 
  4. Bradley S. E. K., Polis C. B., Micks E. A., Steiner M. J., ‘Effectiveness, safety and comparative side effects’, in P. Cason, C. Cwiak, A. Edelment et al. (eds.), Contraceptive Technology, 22nd edn (Burlington, MA: Jones-Bartlett Learning, 2023). Faculty of Sexual and Reproductive Healthcare, UK Medical Eligibility Criteria for Contraceptive Use (UKMEC). 2016.
  5. Faculty of Sexual and Reproductive Healthcare. FSRH CEU Guidance: Drug Interactions with Hormonal Contraception. May 2022.           
  6. Faculty of Sexual and Reproductive Healthcare. UK Medical Eligibility Criteria for Contraceptive Use (UKMEC). 2016. Bradley S. E. K., Polis C. B., Micks E. A., Steiner M. J., op, cit.
  7. Faculty of Sexual and Reproductive Healthcare. UK Medical Eligibility Criteria for Contraceptive Use (UKMEC). 2016. Bradley S. E. K., Polis C. B., Micks E. A., Steiner M. J., op. cit.
  8. Faculty of Sexual and Reproductive Healthcare. FSRH Guideline. Combined Hormonal Contraception. Oct 2023. Faculty of Sexual and Reproductive Healthcare. FSRH Guideline. Progestogen-only Pills. July 2023.     
  9. Kate Muir, ‘The pill’s effects on women can be devastating. We need better information, now.’ Guardian, 11 June 2023. https://www.theguardian.com/society/commentisfree/2023/jun/11/the-pills-effects-on-women-can-be-devastating-we-need-better-information-now
  10. Kemdinum Idu F., Osita Emina M., Oyem Ubaru C., ‘Tear secretion and tear stability of women on hormonal contraceptives’, Journal of Optometry, Jan 2013;6(1):45–50.
  11. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline: Combined Hormonal Contraception. Jan 2019, amended Oct 2023. Faculty of Sexual and Reproductive Healthcare. FSRH Guideline. Progestogen-only Pills. July 2023.

Chapter 3

  1. Office for Health Improvement and Disparities. Official statistics. Reproductive health profiles: statistical commentary. Feb 2024. https://www.gov.uk/government/statistics/reproductive-health-2023-update/reproductive-health-profiles-statistical-commentary
  2. Faculty of Sexual and Reproductive Healthcare. UK Medical Eligibility Criteria for Contraceptive Use (UKMEC). 2016.     
  3. Electronic Medicines Compendium. Levosert 20 micrograms/24 hours intrauterine delivery system. Aug 2024. https://www.medicines.org.uk/emc/product/1789/smpc#gref Electronic Medicines Compendium. Mirena 20 micrograms/24 hours intrauterine delivery system. Jan 2024. https://www.medicines.org.uk/emc/product/1132 Faculty of Sexual and Reproductive Healthcare. FSRH CEU Statement: Benilexa® and Levosert® 52mg LNG-IUDs: extension of licence for contraception to 8 years. Sep 2024.     
  4. Faculty of Sexual and Reproductive Healthcare. FSRH CEU Statement: Extended use of all 52mg LNG-IUDs for up to eight years for contraception. May 2024. https://fsrh.org/Public/News/Articles/FSRH-CEU-Statement–Extended-use-of-all-52mg-LNG-IUDs-for-up-to-eight-years-for-contraception.aspx
  5. Analysis of The Lowdown contraception review data, Aug 2024. 765 reviews for hormonal coil (IUS) and 553 reviews for copper coil (IUD).
  6. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline: Intrauterine contraception. July 2023. 
  7. Ibid.    
  8. Ibid.      
  9. Ibid.      
  10. The Lowdown, Instagram poll Jan 2021, 1,372 respondents.
  11. Melo J., Tschann M., Soon R., Kuwahara M., Kaneshiro B., ‘Women’s willingness and ability to feel the strings of their intrauterine device’, Int J Gynecol Obstet 2017; 137(3): 309–13.
  12. Faculty of Sexual and Reproductive Healthcare. UK Medical Eligibility Criteria for Contraceptive Use (UKMEC). 2016.     
  13. Ibid. Bradley S. E. K., Polis C. B., Micks E. A., Steiner M. J., ‘Effectiveness, safety and comparative side effects’, in P. Cason, C. Cwiak, A. Edelment et al. (eds.), Contraceptive Technology, 22nd edn (Burlington, MA: Jones-Bartlett Learning, 2023).
  14. Faculty of Sexual and Reproductive Healthcare. UK Medical Eligibility Criteria for Contraceptive Use (UKMEC). 2016. Bradley S. E. K., Polis C. B., Micks E. A., Steiner M. J., op. cit.
  15. Dragoman M. V., Simmons K. B., Paulen M. E. et al., ‘Combined hormonal contraceptive (CHC) use among obese women and contraceptive effectiveness: a systematic review’, Contraception 2017; 95:117–29.
  16. Faculty of Sexual and Reproductive Healthcare. UK Medical Eligibility Criteria for Contraceptive Use (UKMEC). 2016. Bradley S. E. K., Polis C. B., Micks E. A., Steiner M. J., op. cit. 
  17. The Lowdown, Instagram poll Feb 2022, 1,976 respondents.
  18. Scottish Government, NHS Inform. Vaginal ring. Dec 2022. https://www.nhsinform.scot/healthy-living/contraception/vaginal-ring 
  19. Helen Burkitt, ‘Can I use tampons or a menstrual cup if I’m using the ring?’ SH:24, Feb 2024. https://sh24.org.uk/help-centre/can-i-use-tampons-or-menstrual-cup-with-the-ring 
  20. Scottish Government, NHS Inform. Vaginal ring. Dec 2022. https://www.nhsinform.scot/healthy-living/contraception/vaginal-ring 
  21. Analysis of The Lowdown contraception recommender tool data, Aug 2024. 61,816 completions.
  22. Bradley S. E. K., Polis C. B., Micks E. A., Steiner M. J., op. cit.
  23. NHS Digital. Sexual and Reproductive Health Services (Contraception) 2022/23. Sep 2023. https://digital.nhs.uk/data-and-information/publications/statistical/sexual-and-reproductive-health-services/2022-23/data-tables
  24. Analysis of The Lowdown contraception review data, July 2024. 557 reviews for copper coil (IUD).
  25. Faculty of Sexual and Reproductive Healthcare. UK Medical Eligibility Criteria for Contraceptive Use (UKMEC). 2016. Bradley S. E. K., Polis C. B., Micks E. A, Steiner M. J., op. cit.
  26. Analysis of The Lowdown contraception review data, July 2024. 154 reviews for fertility awareness methods.
  27. Bradley S. E. K., Polis C. B., Micks E. A., Steiner M. J., op. cit.
  28. Su H. W., Yi Y. C., Wei T. Y., Chang T. C., Cheng C. M., ‘Detection of ovulation, a review of currently available methods’, Bioeng Transl Med 2017 May 16;2(3):238–46.      
  29. Bradley S. E. K., Polis C. B., Micks E. A., Steiner M. J., op. cit.
  30. Faculty of Sexual and Reproductive Healthcare. FSRH CEU Guidance: Fertility Awareness Methods. 2015.
  31. Bradley S. E. K., Polis C. B., Micks E. A., Steiner M. J., op. cit.
  32. Natural Cycles, Publications. https://www.naturalcycles.com/publications 
  33. Analysis of The Lowdown contraception review data, Aug 2024. 105 reviews for Natural Cycles app.
  34. Natural Cycles, Review. https://www.naturalcycles.com/reviews 
  35. United Nations Department of Economic and Social Affairs. World Family Planning 2022, Meeting the changing needs for family planning: Contraceptive use by age and method. View pdf
  36. Berglund Scherwitzl E., Gemzell Danielsson K., Sellberg J. A., Scherwitzl R., ‘Fertility awareness-based mobile application for contraception’, Eur J Contracept Reprod Health Care 2016 Jun;21(3):234–41.     
  37. Khan F., Mukhtar S., Dickinson I. K., Sriprasad S., ‘The story of the condom’, Indian J Urol. 2013 Jan;29(1):12–15. 
  38. Faculty of Sexual and Reproductive Healthcare. UK Medical Eligibility Criteria for Contraceptive Use (UKMEC). 2016. Bradley S. E. K., Polis C. B., Micks E. A., Steiner M. J., op. cit.  
  39.  Ibid.    
  40. Analysis of The Lowdown contraception review data, July 2024. 4 reviews for female condom.
  41. Ibid. 
  42. Ibid. Faculty of Sexual and Reproductive Healthcare. UK Medical Eligibility Criteria for Contraceptive Use (UKMEC). 2016.    
  43. NHS website. How to use diaphragms or caps. January 2024 https://www.nhs.uk/contraception/methods-of-contraception/contraceptive-diaphragm-or-cap/how-to-use-it/
  44. Ibid.
  45. Bradley S. E. K., Polis C. B., Micks E. A., Steiner M. J., op. cit.  
  46. Ibid.
  47. Hancock P., Woodward B. J., Muneer A., Kirkman-Brown J. C., ‘Laboratory guidelines for postvasectomy semen analysis: Association of Biomedical Andrologists, the British Andrology Society and the British Association of Urological Surgeons’, J Clin Pathol 2016 Jul;69(7):655–60.
  48. Faculty of Sexual and Reproductive Healthcare. FSRH Service Standards for Vasectomy in Sexual and Reproductive Health Services. 2024.
  49. Ibid. 
  50. Date S. V., Rokade J., Mule V., Dandapannavar S., ‘Female sterilization failure: review over a decade and its clinicopathological correlation’, Int J Appl Basic Med Res 2014 Jul;4(2):81–5.

Chapter 4

  1. Chavez-MacGregor M., van Gils C. H., van der Schouw Y. T., Monninkhof E., van Noord P. A., Peeters P. H., ‘Lifetime cumulative number of menstrual cycles and serum sex hormone levels in postmenopausal women’, Breast Cancer Res Treat 2008 Mar; 108(1):101–12.      
  2. NHS Website. Heavy Periods. Nov 2021. https://www.nhs.uk/conditions/heavy-periods/
  3. Analysis of The Lowdown endometriosis experience data, July 2024. 156 endometriosis experiences. Treatment rated as effective if scored 4 or 5 on a 5-point scale.
  4. Ibid.
  5. Beelen P., van den Brink M. J., Herman M. C. et al., ‘Levonorgestrel-releasing intrauterine system versus endometrial ablation for heavy menstrual bleeding’, Am J Obstet Gynecol 2021;224:187.e1–187.e10.
  6. Corissa Hollenbeck, ‘The truth about the “Pope Rule” and the seven-day contraceptive pill gap’. Vice Media. Jan 2019. https://www.vice.com/en/article/8xy9qk/the-truth-about-the-pope-rule-and-the-seven-day-contraceptive-pill-gap
  7. Noachtar I. A., Frokjaer V. G., Pletzer B., ‘Mental health symptoms in oral contraceptive users during short-term hormone withdrawal’, JAMA Netw Open 2023;6(9):e2335957.    
  8. Birtch R. L., Olatunbosun O. A., Pierson R. A., ‘Ovarian follicular dynamics during conventional vs. continuous oral contraceptive use’, Contraception 2006 Mar;73(3):235–43.
  9. Royal College of Obstetricians and Gynaecologists (RCOG), ‘Premenstrual Syndrome, Management’ (Green-top Guideline No. 48), 2016. Panay N., The National Association for Premenstrual Syndromes (NAPS), Guidelines on Premenstrual Syndrome. https://www.pms.org.uk/app/uploads/2018/06/guidelinesfinal60210.pdf
  10. Diagnostic and Statistical Manual of Mental Disorders, 5th edn, Text Revision (DSM-5-TR™), 2022.
  11. Reilly T. J., Patel S., Unachukwu I. C., Knox C.-L., Wilson C. A., Craig M. C., Schmalenberger K. M., Eisenlohr-Moul T. A., Cullen A. E.,  ‘The prevalence of premenstrual dysphoric disorder: systematic review and meta-analysis’, Journal of Affective Disorders 2024 Mar;349:534–40.
  12. Eisenlohr-Moul T., Divine M., Schmalenberger K. et al., ‘Prevalence of lifetime self-injurious thoughts and behaviors in a global sample of 599 patients reporting prospectively confirmed diagnosis with premenstrual dysphoric disorder’, BMC Psychiatry 2022;22:199.
  13. Diagnostic and Statistical Manual of Mental Disorders, 5th edn, Text Revision (DSM-5-TR™), 2022.
  14. Ibid.
  15. Svojanovská K., ‘The efficiency of oral contraception containing drospirenone in treating symptoms of premenstrual syndrome or premenstrual dysphoric disorder in gynaecology practice’, Ceska Gynekologie 2010 Oct;75(5):474–80.
  16. Panay N., The National Association for Premenstrual Syndromes (NAPS), Guidelines on Premenstrual Syndrome. https://www.pms.org.uk/app/uploads/2018/06/guidelinesfinal60210.pdf
  17. Royal College of Obstetricians and Gynaecologists (RCOG), op. cit. Panay N., The National Association for Premenstrual Syndromes (NAPS), Guidelines on Premenstrual Syndrome. https://www.pms.org.uk/app/uploads/2018/06/guidelinesfinal60210.pdf
  18. Ibid.
  19. Ibid.
  20. Ibid.
  21. Ibid.
  22. The Migraine Trust. Menstrual Migraine. https://migrainetrust.org/understand-migraine/types-of-migraine/menstrual-migraine/#page-section-1
  23. National Institute for Health and Care Excellence. Clinical Knowledge Summary. Acne Vulgaris. Nov 2023.
  24. Faculty of Sexual and Reproductive Healthcare. FSRH Guideline. Combined Hormonal Contraception. Oct 2023. Arowojolu A. O., Gallo M. F., Lopez L. M., Grimes D. A., ‘Combined oral contraceptive pills for treatment of acne’, Cochrane Database Syst Rev 2012 Jul 11;(7):CD004425.
  25. Lortscher D., Admani S., Satur. N, Eichenfield L. F., ‘Hormonal contraceptives and acne: a retrospective analysis of 2147 patients’, J Drugs Dermatol 2016 Jun 1;15(6):670–74.
  26. World Health Organization, Polycystic Ovary Syndrome. June 2023. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome
  27. Teede H. J., Tay C. T., Laven J. J. E., Dokras A., Moran L. J., Piltonen T. T., Costello M. F., Boivin J., Redman L. M., Boyle J. A., Norman R. J., Mousa A., Joham A. E., The International PCOS Network, ‘Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome’, Eur J Endocrinol 2023;189(2).
  28. Ibid.
  29. Ibid.
  30. UK Government, Drug Safety Update. Cyproterone acetate with ethinylestradiol (co-cyprindiol): balance of benefits and risks remains positive. Dec 2014. https://www.gov.uk/drug-safety-update/cyproterone-acetate-with-ethinylestradiol-co-cyprindiol-balance-of-benefits-and-risks-remains-positive
  31. Ibid.
  32. Analysis of The Lowdown PCOS experience data, July 2024. 182 PCOS experiences.
  33. Greff D., Juhász A. E., Váncsa S., Váradi A., Sipos Z., Szinte J., Park S., Hegyi P., Nyirády P., Ács N., Várbíró S., Horváth E. M., ‘Inositol is an effective and safe treatment in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials’, Reprod Biol Endocrinol 2023 Jan 26;21(1):10.  Fitz V., et al., ‘Inositol for Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis to Inform the 2023 Update of the International Evidence-based PCOS Guidelines’, J Clin Endocrinol Metab, 2024 May 17;109(6):1630-1655. doi: 10.1210/clinem/dgad762.
  34. Motuhifonua S. K., Lin L., Alsweiler J., Crawford T. J., Crowther C. A., ‘Antenatal dietary supplementation with myo-inositol for preventing gestational diabetes’, Cochrane Database Syst Rev 2023 Feb 15;2(2):CD011507.
  35. Giuliani E., As-Sanie S., Marsh E. E., ‘Epidemiology and management of uterine fibroids’, Int J Gynaecol Obstet 2020 Apr;149(1):3–9.
  36. Faculty of Sexual and Reproductive Healthcare. FSRH Guideline. Intrauterine contraception. March 2023.
  37. World Health Organization, Endometriosis. March 2023. https://www.who.int/news-room/fact-sheets/detail/endometriosis
  38. Analysis of The Lowdown endometriosis experience data, July 2024. 156 endometriosis experiences.
  39. Kennedy S., Bergqvist A., Chapron C., D’Hooghe T., Dunselman G., Greb R., Hummelshoj L., Prentice A., Saridogan E., on behalf of the ESHRE Special Interest Group for Endometriosis and Endometrium Guideline Development Group, ‘ESHRE guideline for the diagnosis and treatment of endometriosis’, Human Reproduction 2005 Oct;20(10):2698–704.
  40. Endometriosis UK, ‘Years of being “dismissed, ignored and belittled”: Endometriosis UK urges improvement to deteriorating diagnosis times.’ Endometriosis Action Month Press Release, March 2024. https://www.endometriosis-uk.org/diagnosis-report
  41. National Institute for Health and Care Excellence. Endometriosis. NICE guideline [NG73], 2017, updated 2024.
  42. Ibid.
  43. Ibid.
  44. Knez J., Bean E., Nijjar S., Tellum T., Chaggar P., Jurkovic D., ‘Natural progression of deep pelvic endometriosis in women who opt for expectant management’, Acta Obstet Gynecol Scand 2023;102:1298–305.
  45. Sirohi D., Freedman S., Freedman L. et al., ‘Patient experiences of being advised by a healthcare professional to get pregnant to manage or treat endometriosis: a cross-sectional study’, BMC Women’s Health 2023;23:638.
  46. Teal S. B., Turok D. K., Chen B. A. et al., ‘Five-year contraceptive efficacy and safety of a levonorgestrel 52-mg intrauterine system’, Obstet Gynecol 2019;133:63–70.
  47. Li P. S., Peng X. M., Niu X. X., Xu L., Hung Yu Ng E., Wang C. C., Dai J. F., Lu J., Liang R. N., ‘Efficacy of acupuncture for endometriosis-associated pain: a multicenter randomized single-blind placebo-controlled trial’, Fertil Steril 2023 May;119(5):815–23.
  48. Taran F. A., Stewart E. A., Brucker S., ‘Adenomyosis: epidemiology, risk factors, clinical phenotype and surgical and interventional alternatives to hysterectomy’, Geburtshilfe Frauenheilkd 2013 Sep;73(9):924–31.
  49. National Institute for Health and Care Excellence. Heavy menstrual bleeding: assessment and management. NICE guideline [NG88]. March 2018, updated May 2021. Becker C. M., Bokor A., Heikinheimo O. et al., ‘ESHRE guideline: endometriosis’, Hum Reprod Open 2022:hoac009.
  50. NHS Health Research Authority, Semaglutide vs Metformin in polycystic ovary syndrome (PCOS). https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/semaglutide-vs-metformin-in-polycystic-ovary-syndrome-pcos/
  51. Sharma A., Welt C. K., ‘Practical approach to hyperandrogenism in women’, Med Clin North Am 2021 Nov;105(6):1099–116.
  52. Qin R., Tian G., Liu J., Cao L., ‘The gut microbiota and endometriosis: from pathogenesis to diagnosis and treatment’, Front Cell Infect Microbiol 2022 Nov 24;12:1069557.     
  53. Coleman H., et al., BASHH Summary Guidance on Testing for Sexually Transmitted Infections, 2023

Chapter 5

  1. The Lowdown Instagram poll March 2022, 606 respondents.
  2. Skovlund C. W., Mørch L. S., Kessing L. V., Lidegaard Ø., ‘Association of hormonal contraception with depression’, JAMA Psychiatry 2016;73(11):1154–62.
  3. Faculty of Sexual and Reproductive Healthcare. FSRH CEU Statement: Response to published study: Association of Hormonal Contraception with Depression. Oct. 2016. https://www.fsrh.org/news/ceu-response-to-published-study-association-of-hormonal/
  4. Skovlund C. W., Mørch L. S., Kessing L. V., Lange T., Lidegaard Ø., ‘Association of hormonal contraception with suicide attempts and suicides’, Am J Psychiatry 2018 Apr 1;175(4):336–42.
  5. Worly B. L., Gur T. L., Schaffir J., ‘The relationship between progestin hormonal contraception and depression: a systematic review’, Contraception 2018 Jun;97(6):478–89.           
  6. Faculty of Sexual and Reproductive Healthcare. FSRH CEU Statement to published systematic review: The relationship between progestin hormonal contraception and depression. March 2018. https://www.fsrh.org/standards-and-guidance/documents/fsrh-ceu-statement-to-published-systematic-review/
  7. Sangthawan M., Taneepanichskul S., ‘A comparative study of monophasic oral contraceptives containing either drospirenone 3 mg or levonorgestrel 150 microg on premenstrual symptoms’, Contraception 2005;71:1–7. Kelly S., Davies E., Fearns S. et al., ‘Effects of oral contraceptives containing ethinylestradiol with either drospirenone or levonorgestrel on various parameters associated with well-being in healthy women: a randomized, single-blind, parallel-group, multicentre study’, Clin Drug Investig 2010;30:325–36.
  8. Coffee A. L., Kuehl T. J., Willis S. et al., ‘Oral contraceptives and premenstrual symptoms: comparison of a 21/7 and extended regimen’, Am J Obstet Gynecol 2006;195:1311–19.
  9. Robertson E., Thew C., Thomas N., Karimi L., Kulkarni J., ‘Pilot data on the feasibility and clinical outcomes of a nomegestrol acetate oral contraceptive pill in women with premenstrual dysphoric disorder’, Front Endocrinol (Lausanne) 2021 Sep 24;12:704488.
  10. Rosenberg M. J., Waugh M. S., Stevens C. M., ‘Smoking and cycle control among oral contraceptive users’, Am J Obstet Gynecol 1996;174(2):628–32.
  11. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guidance. Problematic Bleeding with Hormonal Contraception. Clinical Effectiveness Unit. July 2025.
  12. Analysis of The Lowdown contraception review data, July 2024. 557 reviews for copper coil (IUD).
  13. Gallo M. F., Nanda K., Grimes D. A. et al., ‘20 μg versus >20 μg estrogen combined oral contraceptives for contraception’, Cochrane Database Syst Rev 2013;CD003989.
  14. Lopez L. M., Grimes D. A., Gallo M. F. et al., ‘Skin patch and vaginal ring versus combined oral contraceptives for contraception’, Cochrane Database Syst Rev 2013;CD003552.
  15. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline: Problematic Bleeding with Hormonal Contraception. July 2015. https://www.fsrh.org/standards-and-guidance/documents/ceuguidanceproblematicbleedinghormonalcontraception/
  16. Analysis of The Lowdown contraception review data, July 2024. 581 implant reviews.
  17. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline: Problematic Bleeding with Hormonal Contraception. July 2015. https://www.fsrh.org/standards-and-guidance/documents/ceuguidanceproblematicbleedinghormonalcontraception/ Mansour D., Fraser I. S., Edelman A. et al., ‘Can initial vaginal bleeding patterns in etonogestrel implant users predict subsequent bleeding in the first 2 years of use?’, Contraception 2019;100:264–8. 
  18. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline: Progestogen-only Pills. Aug 2022, amended July 2023. https://www.fsrh.org/standards-and-guidance/documents/cec-guideline-pop/
  19. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline: Problematic Bleeding with Hormonal Contraception. July 2015. https://www.fsrh.org/standards-and-guidance/documents/ceuguidanceproblematicbleedinghormonalcontraception/
  20. Analysis of The Lowdown contraception review data, July 2024. 263 injection reviews.
  21. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline: Problematic Bleeding with Hormonal Contraception. July 2015. https://www.fsrh.org/standards-and-guidance/documents/ceuguidanceproblematicbleedinghormonalcontraception/
  22. Hubacher D., Chen P.-L., Park S. ‘Side effects from the copper IUD: do they decrease over time?’, Contraception 2009;79:356–62. Sanders J. N., Adkins D. E., Kaur S. et al., ‘Bleeding, cramping, and satisfaction among new copper IUD users: a prospective study’, PloS One 2018;13:e0199724.
  23. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline: Progestogen-only Pills. Aug 2022, amended July 2023. https://www.fsrh.org/standards-and-guidance/documents/cec-guideline-pop
  24. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline: Problematic Bleeding with Hormonal Contraception. July 2015.https://www.fsrh.org/standards-and-guidance/documents/ceuguidanceproblematicbleedinghormonalcontraception/
  25. Analysis of The Lowdown contraception review data, July 2024. 1,298 progestogen-only pill reviews, 263 injection reviews.
  26. Teal S. B., Turok D. K., Chen B. A. et al., ‘Five-year contraceptive efficacy and safety of a levonorgestrel 52-mg intrauterine system’, Obstet Gynecol 2019;133:63–70. Faculty of Sexual and Reproductive Healthcare. FSRH Guideline. Intrauterine contraception. July 2023. https://www.fsrh.org/standards-and-guidance/documents/ceuguidanceintrauterinecontraception/
  27. Ibid.
  28. Analysis of The Lowdown contraception review data, July 2024. 767 hormonal coil (IUS) reviews.
  29. Analysis of The Lowdown contraception review data, July 2024. 526 Mirena coil reviews, 23 Levosert reviews, 98 Jaydess reviews, 117 Kyleena reviews.
  30. Burrows L. J., Basha M., Goldstein A.T., ‘The effects of hormonal contraceptives on female sexuality: a review’, J Sex Med 2012 Sep;9(9):2213–23.
  31. Schaffir J., ‘Hormonal contraception and sexual desire: a critical review’, J Sex Marital Ther 2006 Jul–Sep;32(4):305–14.
  32. Higgins J. A., Smith N. K., ‘The sexual acceptability of contraception: reviewing the literature and building a new concept’, J Sex Res 2016 May–Jun;53(4–5):417–56.
  33. Caruso S., Malandrino C., Cicero C., Ciancio F., Cariola M., Cianci A., ‘Quality of sexual life of women on oral contraceptive continued-regimen: pilot study’, J Sex Med 2013 Feb;10(2):460–66.
  34. ​​Pastor Z., Holla K., Chmel R., ‘The influence of combined oral contraceptives on female sexual desire: a systematic review’, Eur J Contracept Reprod Health Care 2013 Feb;18(1):27–43. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline. Combined hormonal contraception. Oct 2023. https://www.fsrh.org/standards-and-guidance/documents/combined-hormonal-contraception/
  35. Higgins J. A., Smith N. K., ‘The sexual acceptability of contraception: reviewing the literature and building a new concept’, J Sex Res 2016 May–Jun;53(4–5):417–56. Davis S. R., Tran J., ‘Testosterone influences libido and well being in women’, Trends Endocrinol Metab 2001 Jan–Feb;12(1):33–7.
  36. Zethraeus N., Dreber A., Ranehill E., Blomberg L., Labrie F., von Schoultz B., Johannesson M., Hirschberg A. L., ‘Combined oral contraceptives and sexual function in women – a double-blind, randomized, placebo-controlled trial’, J Clin Endocrinol Metab 2016 Nov;101(11):4046–53.
  37. Analysis of The Lowdown contraception review data, July 2024. 2,466 combined pill reviews, 97 patch reviews, 18 vaginal ring reviews.
  38. Schaffir J. A., Isley M. M., Woodward M., ‘Oral contraceptives vs injectable progestin in their effect on sexual behavior’, Am J Obstet Gynecol 2010 Dec;203(6):545.e1–5.
  39. Analysis of The Lowdown contraception review data, July 2024. 1,298 progestogen-only pill reviews, 767 hormonal coil (IUS) reviews, 581 implant reviews, 263 injection reviews.
  40. National Institute for Health and Care Excellence. Acne vulgaris: management. NICE guideline [NG198] Dec 2023. https://www.nice.org.uk/guidance/ng198
  41. Analysis of The Lowdown contraception review data, July 2024. 628 combined pill reviews. 334 progestogen-only pill reviews. This question was added at a later date following the launch of the website.
  42. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline: Progestogen-only Pills. Aug 2022, amended July 2023. https://www.fsrh.org/standards-and-guidance/documents/cec-guideline-pop
  43. Analysis of The Lowdown contraception review data, July 2024. 129 implant reviews. 65 injection reviews. This question was added at a later date following the launch of the website.
  44. Analysis of The Lowdown contraception review data, July 2024. 228 hormonal coil (IUS) reviews. This question was added at a later date following the launch of the website.
  45. Kanelleas A. I., Thornton S., Berth-Jones J., ‘Suggestions for effective contraception in isotretinoin therapy’, Br J Clin Pharmacol 2009 Jan;67(1):137–8.
  46. Faculty of Sexual and Reproductive Healthcare. FSRH CEU Statement: Contraception and Weight Gain. Aug 2019. https://www.fsrh.org/Public/Documents/fsrh-ceu-statement-contraception-and-weight-gain.aspx
  47. Ibid.
  48. Analysis of The Lowdown contraception review data, July 2024. 262 injection reviews.
  49. Oelkers W. H., ‘Drospirenone in combination with estrogens: for contraception and hormone replacement therapy’, Climacteric 2005 Oct;8 Suppl 3:19–27.
  50. Lopez L. M., Ramesh S., Chen M., Edelman A., Otterness C., Trussell J., Helmerhorst F. M., ‘Progestin-only contraceptives: effects on weight’, Cochrane Database Syst Rev 2016 Aug 28;2016(8):CD008815.
  51. Analysis of The Lowdown contraception review data, July 2024. 1,293 progestogen-only pill reviews. 579 implant reviews. 765 hormonal coil (IUS) reviews.
  52. Hirschberg A. L., Byström B., Carlström K., von Schoultz B., ‘Reduced serum cholecystokinin and increase in body fat during oral contraception’, Contraception 1996 Feb;53(2):109–13.
  53. Gallo M. F., Lopez L. M., Grimes D. A., Carayon F., Schulz K. F., Helmerhorst F. M., ‘Combination contraceptives: effects on weight’, Cochrane Database Syst Rev 2014 Jan 29;2014(1):CD003987.
  54. Analysis of The Lowdown contraception review data, July 2024. 2,432 combined pill reviews. 97 patch reviews. 18 vaginal ring reviews.
  55. Faculty of Sexual and Reproductive Healthcare. FSRH CEU Statement: Contraception and Weight Gain. Aug 2019. https://www.fsrh.org/Public/Documents/fsrh-ceu-statement-contraception-and-weight-gain.aspx
  56. Analysis of The Lowdown contraception review data, July 2024. 2,466 combined pill reviews, 1,298 progestogen-only pill reviews.
  57. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline. Progestogen-only pills. Aug 2022. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline. Combined hormonal contraception. Oct 2023.
  58. Analysis of The Lowdown contraception review data, July 2024. 2,466 combined pill reviews, 1,298 progestogen-only pill reviews.
  59. Waetjen L. E., Crawford S. L., Chang P. Y., Reed B. D., Hess R., Avis N. E., Harlow S. D., Greendale G. A., Dugan S. A., Gold E. B., ‘Study of Womenʼs Health Across the Nation (SWAN). Factors associated with developing vaginal dryness symptoms in women transitioning through menopause: a longitudinal study’, Menopause 2018 Oct;25(10):1094–104.
  60. Sabatini R., Cagiano R., ‘Comparison profiles of cycle control, side effects and sexual satisfaction of three hormonal contraceptives’, Contraception 2006 Sep;74(3):220–23.
  61. Analysis of The Lowdown contraception review data, July 2024. 2,466 combined pill reviews, 1,298 progestogen-only pill reviews, 581 implant reviews, 263 injection reviews.

Chapter 6

  1. The Faculty of Sexual and Reproductive Healthcare. UK Medical Eligibility Criteria for Contraceptive Use. (UKMEC). 2016. Amended September 2019. https://www.fsrh.org/Public/Standards-and-Guidance/uk-medical-eligibility-criteria-for-contraceptive-use-ukmec
  2. Mørch, L., Skovlund, C., Hannaford, P., Iversen, L., Fielding, S., Lidegaard, Ø., ‘Contemporary hormonal contraception and the risk of breast cancer’, Obstetrical & Gynecological Survey 2018.
  3. Fitzpatrick D., Pirie K., Reeves G., Green J., Beral V., ‘Combined and progestagen-only hormonal contraceptives and breast cancer risk: a UK nested case-control study and meta-analysis’, PLoS Med 2023 Mar 21;20(3):e1004188.    
  4. Ibid.
  5. Ibid.
  6. Ibid.
  7. Cancer Research UK. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer/incidence-invasive#heading-One Accessed Aug 2024.
  8. Cancer Research UK. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer#heading-Four Accessed Aug 2024.
  9. Fitzpatrick D., Pirie K., Reeves G., Green J., Beral V., op. cit.
  10. Faculty of Sexual and Reproductive Healthcare. UK Medical Eligibility Criteria for Contraceptive Use (UKMEC), 2016.
  11. Dyer O., ‘WHO links long term pill use to cervical cancer’, BMJ 2002 Apr 6;324(7341):808.
  12. Cancer Research UK. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervical-cancer/risk-factors#heading-Four Accessed Aug 2024.
  13. Dyer, O., op. cit. Cancer Research UK. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervical-cancer/risk-factors#heading-Four Accessed Aug 2024.      
  14. Cancer Research UK. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervical-cancer/risk-factors#heading-Four Accessed Aug 2024.
  15. Cancer Research UK https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervical-cancer#heading-Four. Accessed Aug 2024.
  16. Cancer Research UK. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervical-cancer#heading-Four. Accessed Aug 2024.
  17. Bahamondes, L., Valeria Bahamondes, M., Shulman, L., ‘Non-contraceptive benefits of hormonal and intrauterine reversible contraceptive methods’, Human Reproduction Update 2015;21(5):640–51.
  18. Havrilesky L. J., Gierisch J. M., Moorman P. G. et al., ‘Oral contraceptive use for the primary prevention of ovarian cancer’, Evid Rep Technol Assess (Full Rep) 2013; (212):1–514.
  19. Iversen, L., Fielding, S., Lidegaard, Ø., Mørch, L., Skovlund, C. and Hannaford, P., ‘Association between contemporary hormonal contraception and ovarian cancer in women of reproductive age in Denmark: prospective, nationwide cohort study’, BMJ 2018 Sep 26;362:k3609.
  20. Havrilesky L. J., Gierisch J. M., Moorman P. G. et al., op. cit.
  21. Iversen L., Sivasubramaniam S., Lee A. J., Fielding S., Hannaford P. C., ‘Lifetime cancer risk and combined oral contraceptives: the Royal College of General Practitioners’ Oral Contraception Study’, Am J Obstet Gynecol 2017 Jun;216(6):580.e1–580.e9. Collaborative Group on Epidemiological Studies of Ovarian Cancer, Beral V., Doll R., Hermon C. et al., ‘Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls’, Lancet 2008; 371(9609):303–14.
  22. Soini T., Hurskainen R., Grénman S., Mäenpää J., Paavonen J., Pukkala E., ‘Cancer risk in women using the levonorgestrel-releasing intrauterine system in Finland’, Obstet & Gynecol 2014 Aug;124(2 Pt 1):292–9.
  23. Wilailak S. et al., ‘Depot medroxyprogesterone acetate and epithelial ovarian cancer: a multicentre case-control study’, BJOG: An International Journal of Obstetrics & Gynaecology 2012 May;119(6):672–7.
  24. Iversen L., Sivasubramaniam S., Lee A. J., Fielding S., Hannaford P. C., op. cit.
  25. Mueck A. O., Seeger H., Rabe T., ‘Hormonal contraception and risk of endometrial cancer: a systematic review’ 2010 Sep 23; 17(4):R263–71.
  26. Ibid.
  27. Collaborative Group on Epidemiological Studies on Endometrial Cancer, ‘Endometrial cancer and oral contraceptives: an individual participant meta-analysis of 27 276 women with endometrial cancer from 36 epidemiological studies’, Lancet Oncology 2015;16(9):1061–70.
  28. Bahamondes, L., Valeria Bahamondes, M., Shulman, L., op. cit. Felix A. S. et al., ‘Intrauterine devices and endometrial cancer risk: a pooled analysis of the Epidemiology of Endometrial Cancer Consortium’, Int J Cancer 2015 Mar 1;136(5):E410–22.
  29. Iversen L., Sivasubramaniam S., Lee A. J., Fielding S., Hannaford P. C., op. cit.
  30. Cancer Research UK. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/bowel-cancer/risk-factors#heading-Seven Accessed Aug 2014.
  31. European Medicines Agency. Press release: Benefits of combined hormonal contraceptives (CHCs) continue to outweigh risks. 2013.
  32. Ibid.
  33. Ibid.
  34. Hedenmalm K., Samuelsson E., ‘Fatal venous thromboembolism associated with different combined oral contraceptives: a study of incidences and potential biases in spontaneous reporting’, Drug Safety 2005;28(10):907–16.
  35. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline: Combined Hormonal Contraception. Jan 2019, Amended Oct 2023.
  36. Bateson D., Butcher B. E., Donovan C., Farrell L., Kovacs G., Mezzini T., Raynes-Greenow C., Pecoraro G., Read C., Baber R., ‘Risk of venous thromboembolism in women taking the combined oral contraceptive: a systematic review and meta-analysis’. Aust Fam Physician 2016 Jan–Feb;45(1):59–64.
  37. Yonis H, Løkkegaard E, Kragholm K, Granger C B, Møller A L, Mørch L S et al. Stroke and myocardial infarction with contemporary hormonal contraception: real-world, nationwide, prospective cohort study BMJ 2025; 388 :e082801 doi:10.1136/bmj-2024-082801
  38. Ibid.
  39. Faculty of Sexual and Reproductive Healthcare. Responses to recent member enquires – record keeping about vaping/e-cigarette use & discontinuation of spermicide in the UK. https://www.fsrh.org/Public/News/Articles/Responses-to-recent-member-enquires-vaping.aspx Accessed Aug 2024.
  40. Champaloux S. W., Tepper N. K., Monsour M. et al., ‘Use of combined hormonal contraceptives among women with migraines and risk of ischemic stroke’, Am J Obstet Gynecol 2017;216:489.e1–489.e7.
  41. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline: Combined Hormonal Contraception. Jan 2019. Amended Oct 2023.
  42. Ibid.
  43. Ibid.
  44. Yland J. J. et al., ‘Pregravid contraceptive use and fecundability: prospective cohort study’, BMJ 2020;371:m3966.
  45. Faculty of Sexual and Reproductive Healthcare. FSRH Guideline. Intrauterine contraception. July 2023.
  46. Ibid.
  47. Ibid.
  48. Ibid.
  49. Ibid.
  50. Nahum G. G., Kaunitz A. M., Rosen K. et al., ‘Ovarian cysts: presence and persistence with use of a 13.5mg levonorgestrel-releasing intrauterine system’, Contraception 2015;91:412–17. Nahum G. G., Kaunitz A. M., Lukkari-Lax E. et al., ‘Evaluation of the presence and persistence of ovarian cysts in users of a new low-dose levonorgestrel-releasing intrauterine contraceptive system over 5 years’, J Reprod Med 2017;1:383–90.
  51. Faculty of Sexual and Reproductive Healthcare. FSRH Guideline. Intrauterine contraception. July 2023.
  52. Faculty of Sexual and Reproductive Healthcare. FSRH Guideline. Progestogen-only implant. July 2023.
  53. Kang S., Niak A., Gada N. et al., ‘Etonogestrel implant migration to the vasculature, chest wall, and distant body sites: cases from a pharmacovigilance database’, Contraception 2017;96:439–45.
  54. Drug Safety Update: Nexplanon (etonogestrel) contraceptive implants: reports of device in vasculature and lung. 2016. https://www.gov.uk/drug-safety-update/nexplanon-etonogestrelcontraceptive-implants-reports-of-device-in-vasculature-and-lung
  55. Dohle G. R., Diemer T., Kopa Z., Krausz C., Giwercman A., Jungwirth A. et al., ‘European Association of Urology guidelines on vasectomy’, Eur Urol 2002;61:159–63.
  56. Leslie T. A., Illing R. O., McCormick R., Guillebaud J., Cranston D. W., ‘The incidence of chronic post-vasectomy scrotal pain – a prospective cohort study with a mean of five years follow-up’, 2013.
  57. Smith A., Lyons A., Ferris J., Richters J., Pitts M., Shelley J., ‘Are sexual problems more common in men who have had a vasectomy? A population-based study of Australian men’, J Sex Med 2010;7(2 Pt 1):736–42. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline. Male and Female Sterilisation. 2014.
  58. Viola A. S., Castro S., Marchi N. M., Bahamondes M. V., Viola C. F., Bahamondes L., ‘Long-term assessment of forearm bone mineral density in postmenopausal former users of depot medroxyprogesterone acetate’, Contraception 2011;84:122–7.
  59. Harel Z., Johnson C. C., Gold M. A., Cromer B., Peterson E., Burkman R. et al., ‘Recovery of bone mineral density in adolescents following the use of depot medroxyprogesterone acetate contraceptive injections’, Contraception 2010; 81:281–91.
  60. Scholes D., Lacroix A. Z., Ichikawa L. E., Barlow W. E., Ott S. M., ‘Change in bone mineral density among adolescent women using and discontinuing depot medroxyprogesterone acetate contraception’, Arch Pediatr Adolesc Med 2005;159:139–44.
  61. Kaunitz A. M, Arias R., McClung M., ‘Bone density recovery after depot medroxyprogesterone acetate injectable contraception use’, Contraception 2008;77:67–76.
  62. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline. Progestogen-only injection, July 2023.
  63. Roland, N. et al., ‘Use of progestogens and the risk of intracranial meningioma: national case-control study’, BMJ 2024;384:e078078.
  64. Weill A., Nguyen P., Yoldjian I., Fontanel S., Froelich S., Coste J., ‘Exposition prolongée à de fortes doses d’acétate de cyprotérone et risque de méningiome chez la femme: une recherche-action de santé publique en France’, Revue d’Épidémiologie et de Santé Publique 2020;68:S3–4. Faculty of Sexual and Reproductive Healthcare. FSRH CEU Statement: New manufacturer/MHRA advice regarding nomegestrol acetate – how does this affect prescribing of Zoely®? April 2023.
  65. Faculty of Sexual and Reproductive Healthcare. FSRH CEU Statement: Response to new study by Roland et al. (2024), ‘Use of progestogens and the risk of intracranial meningioma: national case-control study’. March 2024.
  66. Roland, N. et al., op. cit.
  67. Faculty of Sexual and Reproductive Healthcare. FSRH CEU Statement: Response to new study by Roland et al. (2024), ‘Use of progestogens and the risk of intracranial meningioma: national case-control study’. March 2024.

Chapter 7

  1. Trussell J., Vaughan B., ‘Contraceptive failure, method-related discontinuation and resumption of use: results from the 1995 National Survey of Family Growth’, Fam Plann Perspect 1999 Mar–Apr;31(2):64–72, 93.
  2. Simmons R. G., Sanders J. N., Geist C., Gawron L., Myers K., Turok D. K., ‘Predictors of contraceptive switching and discontinuation within the first 6 months of use among Highly Effective Reversible Contraceptive Initiative Salt Lake study participants’, Am J Obstet Gynecol 2019 Apr;220(4):376.e1–376.e12.
  3. Analysis of The Lowdown contraception review data, July 2024. 75 responses to the question ‘Why did you stop using (this method of contraception)?’
  4. Faculty of Sexual and Reproductive Healthcare. UK Medical Eligibility Criteria for Contraceptive Use (UKMEC). September 2019.
  5. Hoffman B. L., Schorge J. O., Bradshaw K. D., Halvorson L. M., Schaffer J. I., Corton M. M. (eds.), Williams Gynecology 3rd edn (New York: McGraw-Hill Education, 2016).
  6. Dr Wendy Jones MBE, ‘MRPharmS and the Breastfeeding Network’, Emergency hormonal contraception and breastfeeding factsheet. September 2019 https://www.breastfeedingnetwork.org.uk/factsheet/ehc/
  7. The Faculty of Sexual and Reproductive Healthcare, FSRH Statement: Ulipristal Acetate and Breastfeeding, January 2025.
  8. Electronic medicines compendium, Ulipristal 30mg film-coated tablets, Healthcare professionals SmPC, August 2023 https://www.medicines.org.uk/emc/product/14200/smpc#gref
  9. Butcher, B. et al., ‘Risk of venous thromboembolism in women taking the combined oral contraceptive: a systematic review and meta-analysis’, Aust Fam Physician 2016 Jan–Feb;45(1):59–64.
  10. Faculty of Sexual and Reproductive Healthcare. Contraception for Women Aged Over 40 years. July 2023.
  11. Ibid.
  12. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline, Male and Female Sterilisation. September 2014.
  13. Faculty of Sexual and Reproductive Healthcare. FSRH Guideline: Combined Hormonal Contraception. October 2023. Faculty of Sexual and Reproductive Healthcare. FSRH Guideline. Progestogen-only Pills. July 2023.
  14. The Lowdown Instagram poll April 2023, 1,362 respondents.
  15. Sarah Hill. The Pill and Sexual Orientation. May 2020.
  16. Little A. C., Jones B. C., Penton-Voak I. S., Burt D. M., Perrett D. I., ‘Partnership status and the temporal context of relationships influence human female preferences for sexual dimorphism in male face shape’, Proc Biol Sci 2002 Jun 7;269(1496):1095–100. Alvergne A., Lummaa V., ‘Does the contraceptive pill alter mate choice in humans?’, Trends Ecol Evol 2010 Mar;25(3):171–9.
  17. Marcinkowska U. M., Hahn A. C., Little A. C., DeBruine L. M., Jones B. C., ‘No evidence that women using oral contraceptives have weaker preferences for masculine characteristics in men’s faces’, PLoS One 2019 Jan 10;14(1):e0210162. Jones B. C., Hahn A. C., Fisher C. I., Wang H., Kandrik M., Han C., Fasolt V., Morrison D., Lee A. J., Holzleitner I. J., O’Shea K. J., Roberts S. C., Little A. C., DeBruine L. M., ‘No compelling evidence that preferences for facial masculinity track changes in women’s hormonal status’, Psychol Sci 2018 Jun; 29(6):996–1005. Jern P., Kärnä A., Hujanen J., Erlin T., Gunst A., Rautaheimo H., Öhman E., Roberts S. C., Zietsch B. P., ‘A high-powered replication study finds no effect of starting or stopping hormonal contraceptive use on relationship quality’, Evolution and Human Behavior 2018;39(4):373–9.

Chapter 8

  1. Tanne J. H., ‘Problems with contraception play big part in unplanned pregnancies, study says’, BMJ 2008 May 17;336(7653):1095.
  2. The Lowdown Instagram poll February 2022.     
  3. Ibid.
  4. Li R. H. W., Lo S. S. T., Gemzell-Danielsson K., Fong C. H. Y., Ho P. C., Ng E. H. Y., ‘Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial’, Lancet 2023 Sep 9;402(10405):851–8.
  5. The Lowdown Instagram poll February 2022.
  6. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline, Emergency Contraception. July 2023.
  7. Dr Wendy Jones MBE, MRPharmS and the Breastfeeding Network. Emergency hormonal contraception and breastfeeding factsheet. September 2019.
  8. The Faculty of Sexual and Reproductive Healthcare. FSRH Statement: Ulipristal Acetate and Breastfeeding. January 2025.
  9. Electronic Medicines Compendium. Ulipristal 30mg film-coated tablets. Healthcare professionals SmPC. August 2023
  10. Faculty of Sexual and Reproductive Health. FSRH Clinical Guideline, Emergency Contraception. July 2023.
  11. Office for Health Improvement & Disparities, Abortion statistics, England and Wales: 2022. May 2024
  12. Ibid
  13. Sevinç F., Oskovi-Kaplan Z. A., Çelen Ş., Ozturk Atan D., Topçu H. O., ‘Identifying the risk factors and incidence of Asherman Syndrome in women with post-abortion uterine curettage’, J Obstet Gynaecol Res 2021 Apr;47(4):1549–55.
  14. Office for Health Improvement & Disparities, Abortion statistics, England and Wales: 2022. May 2024
  15. The Lowdown survey, April 2022. 572 respondents.
  16. Office for Health Improvement & Disparities, Abortion statistics, England and Wales: 2022. May 2024.
  17. Ibid.
  18. Reynolds-Wright J. J., Johnstone A., McCabe K. et al., ‘Telemedicine medical abortion at home under 12 weeks’ gestation: a prospective observational cohort study during the COVID-19 pandemic’, BMJ Sexual & Reproductive Health 2021;47:246–51.
  19. Office for Health Improvement & Disparities, Abortion statistics, England and Wales: 2022. May 2024
  20. National Institute for Health and Care Excellence. Abortion Care. NICE guideline [NG140] September 2019.
  21. Schreiber C. A., Sober S., Ratcliffe S., Creinin M. D., ‘Ovulation resumption after medical abortion with mifepristone and misoprostol’, Contraception 2011 Sep;84(3):230–33.
  22. Nitsun M., Szokol J. W., Saleh H. J., Murphy G. S., Vender J. S., Luong L., Raikoff K., Avram M. J., ‘Pharmacokinetics of midazolam, propofol, and fentanyl transfer to human breast milk’, Clin Pharmacol Ther 2006 Jun;79(6):549 –57.
  23. The Lowdown survey, April 2022. 572 respondents.
  24. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline, Quick Starting Contraception. April 2017.
  25. Cameron I. T., Baird D. T., ‘The return to ovulation following early abortion: a comparison between vacuum aspiration and prostaglandin’, Acta Endocrinol (Copenh) 1988 Jun;118(2):161–7.
  26. Charlotte Proudman, ‘Think abortion is legal in Great Britain? Ask the two women currently facing life sentences’. Guardian, 19 Aug 2022. https://www.theguardian.com/commentisfree/2022/aug/19/abortion-legal-great-britain-women-life-sentences

Chapter 9

  1. The Lowdown survey, March 2023. 558 respondents.
  2. Ibid.
  3. Taylor A., ‘ABC of subfertility: extent of the problem’, BMJ 2003 Aug 23; 327(7412):434–6.
  4. Faculty of Sexual and Reproductive Health. FSRH Clinical Guideline, Combined Hormonal Contraception. October 2023.
  5. Yland J. et al., ‘Pregravid contraceptive use and fecundability: prospective cohort study’, BMJ 2020;371:m3966.
  6. Electronic Medicines Compendium. Datapharm Communications Ltd. SmPc for Depo-Provera 150mg/ml Injection Sterile suspension for injection.
  7. Pardthaisong T., Gray R. H., McDaniel E. B., ‘Return to fertility after the discontinuation of depot medroxyprogesterone acetate and intrauterine devices in Northern Thailand’, Lancet 1980;1:509–12.
  8. Evers, J., ‘Female subfertility’, Lancet 2002 Jul 13;360(9327):151–9.
  9. Tommy’s Website. Drugs and Medicine in Pregnancy. August 2023.
  10. Cristodoro M., Zambella E., Fietta I., Inversetti A., Di Simone N., ‘Dietary patterns and fertility’, Biology (Basel) 2024 Feb 19;13(2):131.
  11. James J. E., ‘Maternal caffeine consumption and pregnancy outcomes: a narrative review with implications for advice to mothers and mothers-to-be’, BMJ Evid Based Med 2021 Jun;26(3):114–15.
  12. Tommy’s Website. Drugs and Medicine in Pregnancy. August 2023.
  13. NHS Website. Low sperm count. January 2024.
  14. NHS Website. Infertility. August 2023.
  15. Stavridis K., Triantafyllidou O., Pisimisi M., Vlahos N., ‘Bisphenol-A and female fertility: an update of existing epidemiological studies’, J Clin Med 2022 Dec 5;11(23):7227. Mínguez-Alarcón L., Messerlian C., Bellavia A., Gaskins A. J., Chiu Y. H., Ford J. B., Azevedo A. R., Petrozza J. C., Calafat A. M., Hauser R., Williams P.L., Earth Study Team, ‘Urinary concentrations of bisphenol A, parabens and phthalate metabolite mixtures in relation to reproductive success among women undergoing in vitro fertilization’, Environ Int 2019 May;126:355–62.
  16. McKinnon C. J., Joglekar D. J., Hatch E. E., Rothman K. J., Wesselink A. K., Willis M. D., Wang T. R., Mikkelsen E. M., Eisenberg M. L., Wise L. A., ‘Male personal heat exposures and fecundability: a preconception cohort study’, Andrology 2022 Nov;10(8):1511–21.
  17. Hajizadeh Maleki B., Tartibian B., ‘Long-term low-to-intensive cycling training: impact on semen parameters and seminal cytokines’, Clin J Sport Med 2015 Nov;25(6):535–40.
  18. Njagi P., Groot W., Arsenijevic J., Dyer S., Mburu G., Kiarie J., ‘Financial costs of assisted reproductive technology for patients in low- and middle-income countries: a systematic review’, Human Reprod Open 2023;2023(2):hoad007.
  19. The British Fertility Society. What Exactly is Ovarian Reserve? November 2015.
  20. NHS Website. Polycystic Ovary Syndrome Treatment. October 2022.
  21. Greff, D., Juhász, A. E., Váncsa, S. et al., ‘Inositol is an effective and safe treatment in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials’, Reprod Biol Endocrinol 2023 Jan;21(1):10.
  22. Montanino O. M., Buonomo G., Calcagno M., Unfer V., ‘Effects of myo-inositol plus alpha-lactalbumin in myo-inositol-resistant PCOS women’, J Ovarian Res 2018 May 10;11(1):38.
  23. Meuleman C., Vandenabeele B., Fieuws S., Spiessens C., Timmerman D., D’Hooghe T., ‘High prevalence of endometriosis in infertile women with normal ovulation and normospermic partners’, Fertil Steril 2009;92:68–74.
  24. National Institute for Health and Care Excellence. Endometriosis diagnosis and management. NICE Guideline [NG73]. April 2024.
  25. Endometriosis UK Website. Endometriosis, Fertility and Pregnancy. January 2023.
  26. Ibid.
  27. Hunt S., Vollenhoven B., ‘Pelvic inflammatory disease and infertility’, Aust J Gen Pract 2023 Apr;52(4):215–18.
  28. eClinicalMedicine. ‘The current status of IVF: are we putting the needs of the individual first?’ eClinicalMedicine 2023 Nov 23;65:102343.
  29. National Institute for Health and Care Excellence. Fertility problems: assessment and treatment. Clinical Guideline [CG156]. September 2017.
  30. Human Fertilisation and Embryology Authority. Fertility treatment 2022: preliminary trends and figures. July 2024.
  31. The Fawcett Society. Paths to parenthood: Navigating fertility at work. September 2023.
  32. Connie Dimsdale, ‘Same-sex couples are remortgaging and sacrificing “heating and eating” for fertility treatment’. inews, 29 Oct 2023. https://inews.co.uk/news/same-sex-couples-remortgaging-sacrificing-heating-eating
  33. Gov.UK. Maria Caulfield and Department of Health, Press Release. IVF law change to benefit couples with fertility issues. Oct 2023.
  34. Human Fertilisation and Embryology Authority. Ethnic diversity in fertility treatment 2021. Dec 2023. https://www.hfea.gov.uk/about-us/publications/research-and-data/ethnic-diversity-
  35. Ibid.

Chapter 10

  1. Schummers L., Hutcheon J. A., Hernandez-Diaz S., Williams P. L., Hacker M. R., VanderWeele T. J., Norman W.V., ‘Association of short interpregnancy interval with pregnancy outcomes according to maternal age’, JAMA Intern Med 2018 Dec 1;178(12):1661–70.
  2. Sapire K. E., ‘A study of bleeding patterns with two injectable contraceptives given postpartum and the effect of two non-hormonal treatments’, Adv Contracept 1991;7:379–87. Murphy H. M., ‘Effect of depot medroxyprogesterone acetate on vaginal bleeding in the puerperium’, BMJ 1979;2:1400–1401.
  3. Croxatto H. B., Urbancsek J., Massai R. et al., ‘A multicentre efficacy and safety study of the single contraceptive implant Implanon’, Implanon Study Group. Hum Reprod 1999;14:976–81. Croxatto H. B., ‘Clinical profile of Implanon: a single-rod etonogestrel contraceptive implant’, Eur J Contracept Reprod Health Care 2000;5 Suppl. 2:21–8. Bitzer J., Tschudin S., Alder J. et al., ‘Acceptability and side-effects of Implanon in Switzerland: a retrospective study by the Implanon Swiss Study Group’, Eur J Contracept Reprod Health Care 2004;9:278–84.
  4. Ireland L. D., Goyal V., Raker C. A. et al., ‘The effect of immediate postpartum compared to delayed postpartum and interval etonogestrel contraceptive implant insertion on removal rates for bleeding’, Contraception 2014;90:253–8.
  5. Gurtcheff S. E., Turok D. K., Stoddard G. et al., ‘Lactogenesis after early postpartum use of the contraceptive implant: a randomized controlled trial’, Obstet Gynecol 2011;117:1114–21.
  6. UNICEF United Kingdom. The Baby Friendly Initiative. Breastfeeding in the UK. Accessed Aug 2024.
  7. Tepper N. K., Phillips S. J., Kapp N., Gaffield M. E., Curtis K. M., ‘Combined hormonal contraceptive use among breastfeeding women: an updated systematic review’, Contraception 2016 Sep;94(3):262–74.
  8. Espey E., Ogburn T., Leeman L. et al., ‘Effect of progestin compared with combined oral contraceptive pills on lactation: a randomized controlled trial’, Obstet Gynecol 2012;119:5–13.
  9. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline, Fertility Awareness Methods. June 2015.
  10. Heinemann K., Reed S., Moehner S., Minh T. D., ‘Risk of uterine perforation with levonorgestrel-releasing and copper intrauterine devices in the European Active Surveillance Study on Intrauterine Devices’, Contraception 2015 Apr;91(4):274–9.
  11. Goldthwaite L. M., Shaw K. A., ‘Immediate postpartum provision of long-acting reversible contraception’, Curr Opin Obstet Gynecol 2015;27:460–64.
  12. Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline, Intrauterine contraception. July 2023.
  13. Ibid.
  14. The Faculty of Sexual and Reproductive Healthcare. FSRH Statement: Ulipristal Acetate and Breastfeeding. January 2025.
  15. The Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline, Intrauterine contraception. July 2023.
  16. Carlson, K., Mughal S., Azhar Y., Siddiqui W., Postpartum Depression. StatPearls. October 2022.
  17. Putnick D. L., Sundaram R., Bell E. M., Ghassabian A., Goldstein R. B., Robinson S. L., Vafai Y., Gilman S. E., Yeung E., ‘Trajectories of maternal postpartum depressive symptoms’, Pediatrics 2020 Nov;146(5):e20200857.
  18. HS Website. Symptoms – Postnatal Depression. August 2022.
  19. N Agrawal I., Mehendale A. M., Malhotra R., ‘Risk factors of postpartum depression’, Cureus 2022 Oct 31;14(10):e30898.
  20. Larsen S. V., Mikkelsen A. P., Lidegaard Ø., Frokjaer V. G., ‘Depression associated with hormonal contraceptive use as a risk indicator for postpartum depression’, JAMA Psychiatry 2023;80(7):682–9.
  21. Ti A., Curtis, K. M., ‘Postpartum hormonal contraception use and incidence of postpartum depression: a systematic review’, Eur J Contracept Reprod Health Care 2019;24(2):109–16.
  22. Mbianda J., Mathew B., Levine J., Amico J., ‘Is progestin-only contraception associated with higher incidence of postpartum depression?’, Evidence-Based Practice 2022;25(1):31–2.
  23. Horibe M., Hane Y., Abe J., Matsui T., Kato Y., Ueda N., Sasaoka S., Motooka Y., Hatahira H., Hasegawa S., Kinosada Y., Hara H., Nakamura M., ‘Contraceptives as possible risk factors for postpartum depression: a retrospective study of the Food and Drug Administration adverse event reporting system, 2004–2015’, Nurs Open 2018 Jan 17;5(2):131–8.
  24. Lawrie T. A., Hofmeyr G. J., De Jager M., Berk M., Paiker J., Viljoen E., ‘A double-blind randomised placebo controlled trial of postnatal norethisterone enanthate: the effect on postnatal depression and serum hormones’, Br J Obstet Gynaecol 1998 Oct;105(10):1082–90.

Chapter 11

  1. National Institute of Health and Care Excellence. Clinical Knowledge Summary: Menopause. September 2022. Hickey, M., Szabo, R. A., Hunter, M. S., ‘Non-hormonal treatments for menopausal symptoms’, BMJ 2017 Nov 23;359:j5101.
  2. Stuenkel, C. A. et al., ‘Treatment of symptoms of the menopause: an Endocrine Society clinical practice guideline’, J Clin Endocrinol Metab 2015 Nov;100(11):3975–4011.
  3. British Menopause Society, ‘Understanding Menopause’, Menopause Support Booklet, 2023.
  4. National Institute of Health and Care Excellence. Clinical Knowledge Summary: Menopause. September 2022.
  5. Harper J. C., Phillips S., Biswakarma R., Yasmin E., Saridogan E., Radhakrishnan S., Davies M. C., Talaulikar V., ‘An online survey of perimenopausal women to determine their attitudes and knowledge of the menopause. Womens Health (Lond) 2022;18:17455057221106890.
  6. The Fawcett Society, Menopause and the Workplace. 2022.
  7. The British Menopause Society. National Survey. 2016.
  8. Hickey, M., Szabo, R. A., Hunter, M. S., op. cit.
  9. Sander B., Gordon J. L., ‘Premenstrual mood symptoms in the perimenopause’, Curr Psychiatry Rep 2021 Oct 6;23(11):73.
  10. National Institute for Health and Care Excellence. Menopause: diagnosis and management. NICE Guideline [NG23]. Updated December 2019.
  11. The British Menopause Society. BMS Consensus Statement: Premature Ovarian Insufficiency. March 2024.
  12. van Kasteren Y. M., Schoemaker J., ‘Premature ovarian failure: a systematic review on therapeutic interventions to restore ovarian function and achieve pregnancy’, Hum Reprod Update 1999 Sep–Oct;5(5):483–92.
  13. Faculty of Sexual and Reproductive Healthcare. FSRH Guideline. Contraception for Women Aged Over 40 Years. August 2017. Amended July 2023.
  14. Ibid.
  15. Gov.UK Website. Press Release. Hundreds of thousands of women experiencing menopause symptoms to get cheaper HRT. February 2023.
  16. Gebbie A. E., Glasier A., Sweeting V., ‘Incidence of ovulation in perimenopausal women before and during hormone replacement therapy’, Contraception 1995;52:221–2.
  17. Delbaere I., Verbiest S., Tydén T., ‘Knowledge about the impact of age on fertility: a brief review’, Ups J Med Sci 2020 May;125(2):167–74.
  18. Bouzaglou A., Aubenas I., Abbou H., Rouanet S., Carbonnel M., Pirtea P., Ayoubi J. M. B., ‘Pregnancy at 40 years old and above: obstetrical, fetal, and neonatal outcomes. Is age an independent risk factor for those complications?’, Front Med (Lausanne) 2020 May 27;7:208.
  19. The Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline. Progestogen-only injectables. July 2023.
  20. The Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guideline. Intrauterine contraception. July 2023.
  21. Ibid.
  22. Cartwright B., Robinson J., Seed P. T., Fogelman I., Rymer J., ‘Hormone replacement therapy versus the combined oral contraceptive pill in premature ovarian failure: a randomized controlled trial of the effects on bone mineral density’, J Clin Endocrinol Metab 2016 Sep;101(9):3497–505.
  23. Analysis of The Lowdown contraception review data, July 2024. 767 hormonal coil (IUS) reviews.
  24. Micks E., ‘Sexually transmitted infections in midlife women’, Menopause 2024 May 1;31(5):430–32.

Chapter 12

  1. Sole-Smith V., ‘The point of a period’, Scientific American May 2019.
  2. Oddens B. J., ‘Women’s satisfaction with birth control: a population survey of physical and psychological effects of oral contraceptives, intrauterine devices, condoms, natural family planning, and sterilization among 1466 women’, Contraception 1999 May;59(5):277–86.
  3. The United Nations Population Fund, ‘State of World Population 2022: Seeing the Unseen – The Case for Action in the Neglected Crisis of Unintended Pregnancy’.
  4. Ganatra B., Gerdts C., Rossier C., Johnson B. R. Jr, Tunçalp Ö., Assifi A., Sedgh G., Singh S., Bankole A., Popinchalk A., Bearak J., Kang Z., Alkema L., ‘Global, regional, and subregional classification of abortions by safety, 2010–14: estimates from a Bayesian hierarchical model’, Lancet 2017 Nov 25;390(10110):2372–81.
  5. World Health Organization. ‘WHO issues new guidelines on abortion to help countries deliver lifesaving care’. Departmental news, 2022.
  6. Office for Health Improvements and Disparities. Abortion Statistics, England and Wales: 2022. March 2024.
  7. Analysis of The Lowdown contraception review data, July 2024. 6,742 contraceptive reviews.
  8. Lessard L. N., Karasek D., Ma S., Darney P., Deardorff J., Lahiff M., Grossman D., Foster D. G., ‘Contraceptive features preferred by women at high risk of unintended pregnancy’, Perspect Sex Reprod Health 2012 Sep;44(3):194–200.
  9. World Health Organization. Health topics. Contraception. Accessed 12 Aug 2024.
  10. Kirsten Vogelsong. Better Contraceptives are Coming. Bill & Melinda Gates Foundation. September 2023.
  11. Yamaguchi S., Kaneko M., Narukawa M., ‘Approval success rates of drug candidates based on target, action, modality, application, and their combinations’, Clin Transl Sci 2021 May;14(3):1113–22.
  12. Sertkaya A., Beleche T., Jessup A., Sommers B. D., ‘Costs of drug development and research and development intensity in the US, 2000–2018’, JAMA Netw Open 2024;7(6):e2415445.
  13. European Institute for Gender Equality, Study and Work in the EU: Set Apart by Gender (Vilnius: EIGE, 2018), p. 69.
  14. The Lowdown Instagram poll March 2022, 3,078 participants.
  15. Victoria Waldersee. ‘A third of men would take a “male pill”’, YouGov UK. Jan 2019.
  16. Campelia, G. D., Abbe, C., Nickels, L. M., McElmeel, E., Amory, J. K., ‘“Shared risk”: reframing risk analysis in the ethics of novel male contraceptives’, Contraception 2020 Aug;102(2):67–9.
  17. Behre H. M., Zitzmann M., Anderson R. A., Handelsman D. J., Lestari S. W., McLachlan R. I., Meriggiola M. C., Misro M. M., Noe G., Wu F. C. W., Festin M. P. R., Habib N. A., Vogelsong K. M., Callahan M. M., Linton K. A., Colvard D. S., ‘Efficacy and safety of an injectable combination hormonal contraceptive for men’, J Clin Endocrinol Metab 2016 Dec;101(12):4779–88.
  18. James Dyson Award Website. COSO – The New Way of Male Contraceptive. 2021.
  19.  Balbach M., Rossetti T., Ferreira J., Ghanem L., Ritagliati C., Myers R. W., Huggins D. J., Steegborn C., Miranda I. C., Meinke P. T., Buck J., Levin L. R., ‘On-demand male contraception via acute inhibition of soluble adenylyl cyclase’, Nat Commun 2023 Feb 14;14(1):637.
  20. Heller C. G., Moore D. J., Paulsen C. A., ‘Suppression of spermatogenesis and chronic toxicity in men by a new series of bis(dichloroacetyl) diamines’, Toxicol Appl Pharmacol 1961;3:1–11.
  21. Waller D., Bolick D., Lissner E., Premanandan C., Gamerman G., ‘Azoospermia in rabbits following an intravas injection of Vasalgel™’, Basic Clin Androl 2016;26:6.
  22. Dusenbery M., ‘Set it and forget it’, Scientific American, May 2019.
  23. Kirtane, A. R. et al., ‘A once-a-month oral contraceptive’, Sci Transl Med 2019;11:eaay2602.
  24. The University of Edinburgh Website. News. Women invited to trial new twice-a-year contraceptive jab. 2023.
  25. UNICEF Website. Vaccine Microarray Patches (VMAPs).
  26. Paredes A. J., Ramöller I. K., McKenna P. E., Abbate M. T. A., Volpe-Zanutto F., Vora L. K., Kilbourne-Brook M., Jarrahian C., Moffatt K., Zhang C., Tekko I. A., Donnelly R. F., ‘Microarray patches: breaking down the barriers to contraceptive care and HIV prevention for women across the globe’, Adv Drug Deliv Rev 2021 Jun;173:331–48.
  27. FHI 360 Website. FHI360 conducting trial for Casea S, a biodegradable contraceptive implant. February 2024. 
  28. ISRCTN Registry Website. ISRCTN29802260. Mifepristone 50mg as a weekly contraceptive.

Conclusion

  1. Office for National Statistics, Health state life expectancies by national deprivation deciles, England: 2018 to 2020.
  2. https://digital.nhs.uk/data-and-information/publications/statistical/sexual-and-reproductive-health-services/2022-23/data-tables
  3. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervical-cancer#heading-Zero

Appendix

  1. Department of Health and Social Care. Call for evidence outcome. Results of the ‘Women’s Health – Let’s talk about it survey’ April 2022. https://www.gov.uk/government/calls-for-evidence/womens-health-strategy-call-for-evidence/outcome/results-of-the-womens-health-lets-talk-about-it-survey
  2. British Medical Association. Pressures in general practice data analysis. July 2024. https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/pressures-in-general-practice-data-analysis