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CHC missed pills and EC — DFSRH MCQ

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HardCombined hormonal contraceptionCHC missed pills and ECDFSRH

A 27-year-old using a monophasic combined pill missed the first three active tablets after a 7-day pill-free interval. She had unprotected sex on day 6 of the pill-free interval and again yesterday. She has no contraindications to intrauterine contraception. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: C — Offer a copper IUD for emergency contraception and restart pills

Missing pills at the start of the packet extends the hormone-free interval and creates pregnancy risk from intercourse in the interval and week 1. A copper IUD is the most effective EC and provides ongoing contraception; if oral EC is used, guidance about continuing or delaying hormones matters. Continuing the COC immediately after ulipristal can reduce ulipristal effectiveness.

Reference: FSRH Guideline Emergency Contraception; FSRH Combined Hormonal Contraception