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CHC and diabetes with complications — DFSRH MCQ

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HardCombined hormonal contraceptionCHC and diabetes with complicationsDFSRH

A 36-year-old woman with type 1 diabetes requests the combined vaginal ring. She has background diabetic retinopathy, urine albumin-creatinine ratio 12 mg/mmol and blood pressure 138/84 mmHg. She does not smoke and has no migraine. What is the UKMEC category for CHC?

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Correct answer: C — UKMEC 3/4

Diabetes complicated by microvascular disease or nephropathy makes CHC UKMEC 3/4 because cardiovascular risk is materially higher. The tempting UKMEC 2 category applies to uncomplicated diabetes rather than retinopathy and albuminuria. Glycaemic control alone does not remove the vascular eligibility concern.

Reference: FSRH UKMEC; FSRH Guideline Combined Hormonal Contraception