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CHC and bariatric surgery — DFSRH MCQ

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HardUKMECCHC and bariatric surgeryDFSRH

A 31-year-old woman had Roux-en-Y gastric bypass. She asks for the combined pill and has intermittent diarrhoea after meals. What is the most appropriate advice?

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Correct answer: E — Discuss non-oral contraception because post-bypass absorption may be reduced

The best answer is “Discuss non-oral contraception because post-bypass absorption may be reduced”. Roux-en-Y bypass has a malabsorptive component, and ongoing diarrhoea can further reduce the reliability of oral contraception. A UKMEC category addresses safety rather than efficacy, so it does not remove this absorption concern. Non-oral options such as an IUD, implant, injection, patch or ring can be discussed according to the person’s preferences and ordinary eligibility assessment; oral EC is not planned contraception.

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