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LNG within 72 hours — DFSRH MCQ

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HardEmergency contraceptionLNG within 72 hoursDFSRH

A 32-year-old presents 18 hours after condom failure, is on day 13 of a regular cycle and declines a copper IUD. She takes no hormones or interacting medicines. Which immediate approach is best?

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Correct answer: D — Offer oral emergency contraception now and plan ongoing contraception

The best answer is “Offer oral emergency contraception now and plan ongoing contraception”. Oral EC should be offered without delay when a copper IUD is declined. Starting a POP does not treat the existing pregnancy risk, and waiting for ovulation testing or bleeding sacrifices effectiveness. Choice between ulipristal and levonorgestrel should consider cycle timing and plans for hormonal quick-start, followed by pregnancy-test advice.

Reference: CoSRH/FSRH, Emergency Contraception (amended July 2023): https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-guideline-emergency-contraception03dec2020-amendedjuly2023-11jul.pdf