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Bariatric surgery contraception — DFSRH MCQ

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HardContraception in special circumstancesBariatric surgery contraceptionDFSRH

A 34-year-old woman with a history of bariatric surgery using a Roux-en-Y gastric bypass requests oral contraception. She has regular diarrhoea after meals and wants a reliable reversible method. What is the most appropriate contraceptive method?

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

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Correct answer: E — Etonogestrel implant

After malabsorptive bariatric surgery, non-oral highly effective contraception such as the implant avoids concerns about oral absorption and user error. Oral CHC and oral POP are less reliable choices in this context. UPA and LNG are emergency methods rather than planned contraception. The pearl is to ask which bariatric procedure was performed because restrictive and malabsorptive procedures differ.

Reference: UKMEC 2025; FSRH Guideline: Overweight, Obesity and Contraception