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Previous VTE and CHC — DFSRH MCQ

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HardUKMECPrevious VTE and CHCDFSRH

A 39-year-old woman with a previous unprovoked pulmonary embolism wants contraception. She is no longer anticoagulated, has heavy menstrual bleeding, and asks specifically about the combined transdermal patch. What is the UKMEC category for the patch?

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Correct answer: E — UKMEC 4

Previous VTE makes CHC, including the patch, UKMEC 4 in current UKMEC guidance. The tempting answer is UKMEC 3, but the updated risk classification treats CHC after VTE as an unacceptable risk. Aspirin does not make CHC safe, and UKMEC 1 or 2 would be inappropriate. The pearl is that CHC risks apply to pill, patch and ring because they contain oestrogen.

Reference: UKMEC 2025; FSRH Guideline: Combined Hormonal Contraception