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EC with current POP use — DFSRH MCQ

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HardEmergency contraceptionEC with current POP useDFSRH

A desogestrel-POP user missed pills on Monday and Tuesday, restarted Wednesday morning and had UPSI Tuesday night. She is within the oral-EC window and declines a copper IUD. What combined plan is required?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Choose oral EC, then apply its specific POP restart and condom interval

The best answer is “Choose oral EC, then apply its specific POP restart and condom interval”. UPSI occurred while protection may have been lost, so emergency contraception is indicated even though the POP has restarted. If levonorgestrel EC is chosen, the POP can be continued or restarted immediately with the required short barrier interval. If ulipristal is used, progestogen should generally be delayed for 5 days and barrier precautions extended until POP protection is re-established. A copper IUD remains most effective but has been declined.

Reference: CoSRH/FSRH, Emergency Contraception (amended July 2023): https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-guideline-emergency-contraception03dec2020-amendedjuly2023-11jul.pdf | CoSRH/FSRH, Progestogen-only Pills (August 2022, amended April 2026): https://www.cosrh.org/Public/Public/Documents/ceu-guideline-progestogen-only-pills.aspx