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Further sex after oral EC — DFSRH MCQ

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HardEmergency contraceptionFurther sex after oral ECDFSRH

A 19-year-old took levonorgestrel EC yesterday after UPSI and had UPSI again today before starting ongoing contraception. She remains within the EC window and declines an IUD. What is the best response?

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Correct answer: B — Offer repeat levonorgestrel EC and quick-start suitable ongoing contraception with precautions

The best answer is “Offer repeat levonorgestrel EC and quick-start suitable ongoing contraception with precautions”. Oral EC does not protect subsequent intercourse. Levonorgestrel EC can be repeated after a new UPSI in the same cycle, followed by immediate quick-start of suitable hormonal contraception and method-specific additional precautions. Switching immediately to ulipristal after levonorgestrel may reduce effectiveness through progestogen interaction, while a POP dose is not emergency contraception.

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