A 24 year old nulliparous woman asks for a repeat supply of her combined oral contraception. She mentions that she sometimes forgets to take it and asks about alternatives that don’t rely on daily pill taking. She is a non-smoker, has no contraindications to combined hormonal contraception, and had heavy menstrual bleeding before using oral contraception. This article concentrates on the newer non-oral hormonal methods of contraception (table 1⇓): View this table: Table 1 Summary of newer non-oral hormonal contraceptives Transdermal patch (Evra). Jacek Kutyba/Dreamstime.com Vaginal ring (NuvaRing). Permission from Family Planning NSW Levonorgestrel intrauterine system (IUS) (Mirena). Permission from Family Planning NSW Single rod, progestogen-only implant (Nexplanon or Implanon NXT) Permission from Family Planning NSW User errors are more common with methods that rely on frequent activity—for example, taking a pill daily. Table 2⇓ summarises failure rates for different contraceptive methods (and for a useful counselling tool to use with patients, see the Web Extra figure on bmj.com). The efficacy of the patch (weekly activity) and the vaginal ring (monthly activity) is similar to that of the combined pill.2 An analysis of US data estimated that the combined pill has a failure rate of 0.3% for perfect use (achieved under research conditions) and 9% for typical use (which includes user error) in the first year of use.3 Long acting methods, including the progestogen-only implant and IUS, do not rely on ongoing user administration; they are thus more effective than shorter acting methods, and are sometimes referred to as “fit and forget” methods. View this table: Table 2 Currently …