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Depression and POP — DFSRH MCQ

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HardProgestogen-only methodsDepression and POPDFSRH

A 31-year-old woman with depression treated with sertraline requests a POP because she had nausea on CHC. She has no self-harm risk, no interacting medicines, and wants a reversible method. What is the most appropriate management?

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

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Correct answer: C — Offer POP with counselling about bleeding patterns and routine mental health follow-up

Depression treated with sertraline is not a contraindication to POP use, so it can be offered with counselling and usual mental health follow-up. Declining POP or delaying contraception would create avoidable pregnancy risk. CHC is not required for SSRI users, and copper IUD is not the sole safe option. The pearl is to avoid over-restricting contraception because of stable mental health treatment.

Reference: UKMEC 2025; FSRH Guideline: Progestogen-only Pills