Smoking aged over 35 — DFSRH MCQ

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EasyCombined hormonal contraceptionSmoking aged over 35DFSRH

A 38-year-old woman requests a combined transdermal patch. She smokes 18 cigarettes daily and has a normal blood pressure. What is the UKMEC category for combined hormonal contraception?

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Correct answer: D — UKMEC 4

Age 35 or above with smoking at this level makes CHC UKMEC 4. UKMEC 3 applies to lighter smoking at this age, which is the near-miss. Safer alternatives include progestogen-only or intrauterine methods.

Reference: FSRH Combined Hormonal Contraception Guideline; UKMEC 2025; BNF