Contraception counselling should be an integral part of any adolescent or adult congenital heart disease program. Both the cardiovascular safety and contraceptive efficacy of each contraceptive method should be considered for each cardiac condition. The method recommended should combine acceptability to the woman with the highest efficacy and safety profile. Agent with low dose estrogen combined with varying amounts of progestin referred to as combined oral contraceptives is one of the most effective contraception and is the most used in France. But the thrombogenicity of the estrogen component of combined hormonal contraceptives makes this method unsuitable for many women with severe congenital heart disease. Progestogin only methods offer a good alternative when estrogen is contraindicated, but efficiency differs according contraceptive preparation.