Decompensated cirrhosis and CHC — DFSRH MCQ

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HardUKMECDecompensated cirrhosis and CHCDFSRH

A 39-year-old woman with decompensated cirrhosis, ascites and abnormal clotting requests the combined pill to control bleeding. She has a negative pregnancy test and no current partner. What is the UKMEC category for CHC?

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Correct answer: C — UKMEC 4

Severe decompensated liver disease makes CHC an unacceptable risk and is UKMEC 4. Monthly monitoring does not remove the hepatic and thrombotic concerns. UKMEC 1 or 2 would be inappropriate, while UKMEC 3 understates the severity described. The pearl is that liver disease eligibility depends on compensation status, not merely the diagnosis label.

Reference: UKMEC 2025; FSRH Guideline: Combined Hormonal Contraception