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Oral EC selection — DFSRH MCQ

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ModerateEmergency contraceptionOral EC selectionDFSRH

A 17-year-old attends after a condom split 36 hours ago. She has no safeguarding disclosure, takes no regular medication, and wants oral emergency contraception today because she declines an intrauterine device. What would you advise this patient?

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Correct answer: D — Offer UPA EC because it is generally more effective

The best answer is “Offer UPA EC because it is generally more effective”. When oral emergency contraception is suitable and a copper IUD is declined, ulipristal acetate is generally more effective than levonorgestrel, particularly nearer ovulation. Age under 18 is not a reason to prefer levonorgestrel. A single dose of ulipristal does not require interruption of breastfeeding under current UK guidance, does not protect later intercourse in the cycle, and requires a 5-day delay before starting a progestogen-containing method.

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