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CHC and multiple sclerosis immobility — DFSRH MCQ

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HardUKMECCHC and multiple sclerosis immobilityDFSRH

A patient with multiple sclerosis requests CHC soon after a relapse that has caused prolonged reduced mobility and intermittent wheelchair use. What is the best plan?

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Correct answer: C — Assess VTE risk and favour a medically eligible non-oestrogen method

The best answer is “Assess VTE risk and favour a medically eligible non-oestrogen method”. Multiple sclerosis without prolonged immobility is not itself an absolute bar to CHC, but prolonged reduced mobility increases venous-thromboembolism risk and makes CHC UKMEC 3. A combined patch or ring retains oestrogen-related risk. The decision should assess current function and other VTE factors while offering an eligible POP, implant or intrauterine method.

Reference: CoSRH, UK Medical Eligibility Criteria for Contraceptive Use 2025: https://www.cosrh.org/Common/Uploaded%20files/documents/UKMEC_2025.pdf