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Liver disease contraception — DFSRH MCQ

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HardUKMECLiver disease contraceptionDFSRH

A 40-year-old with compensated cirrhosis after cured hepatitis C wants highly effective contraception and wishes to avoid heavier bleeding. There is no liver tumour and pregnancy can be excluded. Which option best meets her priorities?

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Correct answer: C — Offer a 52 mg levonorgestrel IUD after eligibility assessment

The best answer is “Offer a 52 mg levonorgestrel IUD after eligibility assessment”. UKMEC assessment depends on the severity and type of liver disease rather than a blanket ban on hormonal methods. A 52 mg LNG-IUD is highly effective and can reduce menstrual blood loss. A copper IUD may worsen bleeding, combined methods do not bypass hepatic considerations, and stable compensated disease does not justify withholding contraception.

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