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Perimenopause CHC cessation — DFSRH MCQ

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HardSpecial CircumstancesPerimenopause CHC cessationDFSRH

A healthy 50-year-old non-smoker uses CHC and has normal blood pressure. She asks whether she can continue CHC until age 55 for contraception. What is the best advice?

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Correct answer: D — Switch from CHC to another suitable contraceptive method at age 50

The best answer is “Switch from CHC to another suitable contraceptive method at age 50”. CoSRH advises that CHC may be used until age 50 if medically eligible; after 50, its risks generally outweigh contraceptive benefit and a POP, implant, LNG-IUD or non-hormonal method should be discussed. Raising oestrogen dose increases risk, and CHC suppresses FSH so FSH testing while using it is not a useful way to establish menopause.

Reference: CoSRH/FSRH, Combined Hormonal Contraception (January 2019, amended October 2023): https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-guideline-combined-hormonal-contraception-october-2023.pdf