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Starting contraception after ulipristal — DFSRH MCQ

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HardEmergency contraceptionStarting contraception after ulipristalDFSRH

A woman took ulipristal acetate 48 hours ago and now wants to start a desogestrel POP. She has had no further UPSI. Which sequence preserves ulipristal efficacy and establishes ongoing protection?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Delay POP start until 5 days after ulipristal, then use condoms

The best answer is “Delay POP start until 5 days after ulipristal, then use condoms”. Progestogen started too soon can reduce ulipristal’s ovulation-delaying effect. Hormonal contraception should therefore begin no sooner than 5 days after ulipristal. The desogestrel POP then needs its product-specific additional-precaution interval. Waiting for a period is unnecessary and creates a longer unprotected gap.

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