<span lang="en>Most of the currently available adaptation solutions of VoIP over UMTS are based on the modification of service parameters as the only available reaction against any detected service degradation. On the contrary, in this paper we propose a combined approach where service-level adaptation is considered first and, provided that no suitable parameter combination is capable of providing enough QoE, a change of network state will be suggested. In order to do so we analyze the performance of the end-to-end (e2e) performance metrics in this convergent scenario, the root causes of possible degradations and, finally, the combined effects of the different network segments and their impact on the user perceived QoE. We show the map of best performing VoIP configurations for every state of the network segments. Furthermore, considering each of these configurations, we analyze the acceptability of the service or the convenience of trying to modify the network state. Finally, a lightweight implementation based on simple network state estimation and decision heuristics is proposed and validated in terms of accuracy and responsiveness.</span>