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Sickle cell disease contraception — DFSRH MCQ

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HardContraception in special circumstancesSickle cell disease contraceptionDFSRH

A 25-year-old woman with sickle cell disease has frequent crises and wants reliable contraception. She has heavy painful periods and wants to avoid oestrogen. What is the most appropriate contraceptive method to discuss?

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

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Correct answer: C — POP, implant or intrauterine method based on preferences and eligibility

Many progestogen-only and intrauterine methods can be considered in sickle cell disease, with individualised assessment of bleeding, pain and thrombosis risk. CHC may be less suitable if avoiding oestrogen and depending on risk profile. Withdrawal and monthly EC are less reliable, and sterilisation is not the sole safe approach. The pearl is to avoid assuming complex chronic disease means no reversible options exist.

Reference: UKMEC 2025; FSRH Guideline: Contraception for Women with Medical Conditions