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Starting CHC day 1 — DFSRH MCQ

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HardCombined hormonal contraceptionStarting CHC day 1DFSRH

A patient with no contraindication or recent unprotected intercourse starts a combined pill on day 2 of a normal menstrual period. What additional contraceptive precautions are needed?

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Reveal the answer and explanation

Correct answer: C — Start the combined pill with immediate contraceptive cover

The best answer is “Start the combined pill with immediate contraceptive cover”. CHC started during days 1–5 of a natural menstrual cycle provides immediate contraceptive protection, provided the bleeding represents a normal period and pregnancy risk has been assessed. Starting later generally requires 7 days of additional precautions. Emergency contraception has no indication here because there has been no relevant unprotected intercourse.

Reference: CoSRH/FSRH, Combined Hormonal Contraception (amended October 2023): https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-guideline-combined-hormonal-contraception-october-2023.pdf