- Combined methods include
- combined oral contraceptives (COCs)
- monthly injectables (Mesigyna, Cyclofem)
- Not to be used during first 6 weeks postpartum
due to effect on establishment of lactation
 Not
recommended during first 6 months postpartum
due to decrease in milk production
- Can be used at 6 months postpartum, but not
a preferred option
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Breastfeeding women who have unprotected
intercourse
can safely use COCs for emergency contraception
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Combined estrogen-progestin contraceptives include combined
oral contraceptives (or COCs) and monthly injectable methods
such as Mesigyna and Cyclofem.
Combined contraceptives have been shown to interfere with the
establishment of lactation. For this reason, they should not
be used by breastfeeding women during the first six weeks postpartum
because lactation is not fully established during this period.
Combined estrogen-progestin contraceptives have also been shown
to decrease milk production. For this reason, their use is not
recommended for breastfeeding women from six weeks to six months
postpartum.
At six months postpartum, breastfeeding women can use a combined
estrogen-progestin method, but it is still not a preferred option
for women who want to continue breastfeeding.
If a breastfeeding woman has unprotected intercourse, she can
use combined estrogen-progestin emergency contraceptive pills,
although many breastfeeding women are protected by, and choose
to rely on, LAM. This short-term exposure to estrogen is thought
to have no effect on milk production.
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