Standard operating procedure

Contraception in Perimenopause SOP

How [Organisation Name] assesses, arranges, records and reviews contraception for every patient who could still conceive, including patients taking hormone replacement therapy or testosterone, and advises when contraception can safely stop

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  • Editable Microsoft Word (.docx)
  • Mapped to the CQC standards
  • Optional 3-monthly updates

What's inside

This standard operating procedure is fully drafted and structured, ready to brand and complete for your service. It covers:

  • 1. Purpose
  • 2. Scope
  • 3. Definitions and abbreviations
  • 4. Responsibilities
  • 5. Assessing contraceptive need
  • 6. Eligibility, interactions and remote measurements
  • 7. Contraception alongside HRT and testosterone
  • 8. Referral for fitting and bridging contraception
  • 9. Emergency contraception and possible pregnancy
  • 10. Advising when contraception can stop
  • 11. Safety netting and patient information
  • 12. Records
  • 13. Training and competence
  • 14. Monitoring and audit
  • 15. Related documents
  • 16. Review and version control
  • 17. Appendix A - Administrative Staff Scripted Responses
  • 18. Disclaimer

CQC fundamental standard

Regulation 9 (Person-centred care)
This document is written to evidence that standard. Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Legislation & standards it maps to

  • College of Sexual and Reproductive Healthcare (CoSRH, formerly the Faculty of Sexual and Reproductive Healthcare), Contraception for Women Aged Over 40 Years (as amended).
  • CoSRH, UK Medical Eligibility Criteria for Contraceptive Use (UKMEC 2025).
  • CoSRH guidelines and guidance: Intrauterine Contraception (as amended); Emergency Contraception (as amended); Drug Interactions with Hormonal Contraception.
  • National Institute for Health and Care Excellence (NICE) guideline NG23, Menopause: identification and management (as last updated).
  • British Menopause Society (BMS) Tools for Clinicians, including Progestogens and endometrial protection, and Testosterone replacement in menopause.
  • General Medical Council (GMC), Good practice in proposing, prescribing, providing and managing medicines and devices, including the sections on remote prescribing.
  • Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 9 (Person-centred care), Regulation 11 (Need for consent), Regulation 12 (Safe care and treatment), Regulation 13 (Safeguarding service users from abuse and improper treatment), Regulation 17 (Good governance) and Regulation 20 (Duty of candour).
  • Equality Act 2010.
  • UK General Data Protection Regulation and Data Protection Act 2018; Records Management Code of Practice (2023).
  • Care Quality Commission (CQC) assessment framework: the five key questions (safe, effective, caring, responsive and well-led) and the quality statements of the single assessment framework, and the sector-specific framework for primary care and community services when it replaces them.

Who it applies to

All prescribing clinicians, the [Clinical Lead], the [Registered Manager], the [Safeguarding Lead] and administrative and patient-support staff at [Organisation Name], including self-employed and locum clinicians, for face-to-face and remote care

Glossary

Plain-English explanations of the technical terms and legislation used in this document.

Amenorrhoea
Having no periods.
BMI (body mass index)
A measure of weight relative to height.
BMS (British Menopause Society)
The UK specialist society for menopause care.
BRCA1 and BRCA2
Genes which, when altered, greatly increase breast and ovarian cancer risk.
CHC (combined hormonal contraception)
The combined pill, patch or ring, containing an oestrogen and a progestogen.
CoSRH (College of Sexual and Reproductive Healthcare)
The UK professional body, formerly the Faculty of Sexual and Reproductive Healthcare, that publishes national contraception guidelines.
CQC (Care Quality Commission) assessment framework
The regulator's key questions and quality statements used to assess registered services in England.
Cu-IUD (copper intrauterine device)
A non-hormonal device in the womb that prevents pregnancy; also the most effective emergency contraception.
Data Protection Act 2018
The UK law that sits alongside the UK GDPR on the use of personal data.
DMPA (depot medroxyprogesterone acetate)
The contraceptive injection, given every 13 weeks, which can reduce bone density.
Duty of candour
The legal duty under Regulation 20 to be open and honest with a patient when a notifiable safety incident occurs.
Endometrial protection
Enough progestogen to stop oestrogen causing overgrowth or cancer of the womb lining.
Enzyme inducer
A medicine or herbal product that makes the liver break down some hormones faster, making some contraceptives less effective.
Equality Act 2010
The law protecting people from discrimination, including on grounds of sex and gender reassignment.
FSH (follicle-stimulating hormone)
A hormone that rises as the ovaries stop working; sometimes tested to help decide when contraception can stop.
GMC (General Medical Council)
The regulator of doctors in the UK.
GP (general practitioner)
The patient's registered family doctor.
GPhC (General Pharmaceutical Council)
The regulator of pharmacists in Great Britain.
Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
The regulations setting the fundamental standards CQC-registered providers must meet.
HRT (hormone replacement therapy)
Oestrogen, usually with a progestogen, used to relieve menopausal symptoms. It is not a contraceptive.
IU/L (international units per litre)
The unit used to report FSH results.
LNG-IUS (levonorgestrel intrauterine system)
A hormone-releasing device in the womb; the 52 mg version provides contraception and can protect the womb lining during HRT. CoSRH calls it an LNG-IUD (levonorgestrel intrauterine device).
Migraine with aura
Migraine preceded by warning symptoms such as flashing lights; it rules out combined hormonal contraception.
NICE NG23 (National Institute for Health and Care Excellence guideline NG23)
The national guideline for England on the menopause.
NMC (Nursing and Midwifery Council)
The regulator of nurses and midwives in the UK.
Off-label
Use of a licensed medicine or device outside its licence, for example for longer than the licensed duration.
POI (premature ovarian insufficiency)
Loss of normal ovarian function before 40. Pregnancy is still possible.
POP (progestogen-only pill)
A contraceptive pill containing only a progestogen.
Records Management Code of Practice (2023)
National guidance on how health and care records are managed and how long they are kept.
Reproductive coercion
Controlling someone's decisions about pregnancy or contraception; a form of domestic abuse.
SOP (standard operating procedure)
A step-by-step document describing how a task is carried out.
STI (sexually transmitted infection)
An infection passed on through sexual contact.
UK (United Kingdom)
England, Scotland, Wales and Northern Ireland.
UK GDPR (UK General Data Protection Regulation)
The UK law governing how personal information is used and protected.
UKMEC (UK Medical Eligibility Criteria for Contraceptive Use)
The CoSRH classification (UKMEC 2025) of how safe each method is for people with particular conditions.
Ulipristal acetate and levonorgestrel
The two emergency contraceptive pills available in the UK.
Virilisation
Development of male characteristics, which testosterone can cause in a female fetus.
VTE (venous thromboembolism)
A blood clot in a vein, such as a deep vein thrombosis or pulmonary embolism.

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Related documents

PolicyWomen's Health Scope of Service Policy£44.99
PolicyMenopause Assessment & Diagnosis Policy£44.99
PolicyHRT Prescribing Policy£44.99
PolicyTestosterone Prescribing in Women Policy£44.99

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