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Further UPSI after ulipristal — DFSRH MCQ

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ModerateEmergency contraceptionFurther UPSI after ulipristalDFSRH

A 26-year-old woman took ulipristal acetate 3 days ago for UPSI and has further UPSI today. She declines a Cu-IUD and has not started hormonal contraception. What is the most appropriate management?

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Correct answer: A — Offer repeat oral EC advice and discuss the reduced certainty with ongoing risk

UPA delays ovulation but does not provide ongoing contraceptive cover, so further UPSI creates new risk and requires EC discussion when Cu-IUD is declined. Assuming the previous UPA covers later sex is unsafe. Starting POP today may reduce UPA effect and does not manage the new episode, while LNG-IUD is not EC. The pearl is to emphasise condoms or abstinence after oral EC until an ongoing method is effective.

Reference: FSRH Guideline: Emergency Contraception