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Missed progestogen-only pill — DRCOG MCQ

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HardContraception and Sexual HealthMissed progestogen-only pillDRCOG

A woman takes ulipristal acetate emergency contraception today and plans to start a desogestrel progestogen-only pill. What is the most appropriate advice?

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Correct answer: D — Start desogestrel after five days and use condoms meanwhile

The best answer is “Start desogestrel after five days and use condoms meanwhile”. Progestogen can reduce the effectiveness of ulipristal acetate if started too soon. FSRH advises waiting 5 days before starting hormonal contraception after ulipristal, then using condoms or avoiding sex for the relevant additional interval for the chosen method. This timing differs from advice after levonorgestrel emergency contraception.

Reference: FSRH Guideline: Emergency contraception: https://www.fsrh.org/Common/Uploaded%20files/documents/fsrh-guideline-emergency-contraception03dec2020-amendedjuly2023-11jul.pdf