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EC and quick starting contraception — DFSRH MCQ

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ModerateEmergency contraceptionEC and quick starting contraceptionDFSRH

A 20-year-old attends 18 hours after a condom split. She has regular cycles, takes no medication, and declines an IUD after counselling. She wants the oral method with the least delay before starting ongoing hormonal contraception. What is the most appropriate management?

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

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Correct answer: A — Levonorgestrel emergency contraception with immediate quick start contraception if suitable

LNG-EC can be followed by immediate quick start hormonal contraception when appropriate, so it best fits her priority after declining Cu-IUD. UPA may be more effective in some settings, but requires delaying progestogen for 5 days. No EC is wrong after condom failure, and LNG-IUD is not recommended for EC. The pearl is that EC choice sometimes balances efficacy with timely initiation of ongoing contraception.

Reference: FSRH Guideline: Emergency Contraception; FSRH Guideline: Quick Starting Contraception