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CHC and smoking over 35 — DFSRH MCQ

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HardCombined hormonal contraceptionCHC and smoking over 35DFSRH

A 38-year-old who smokes 18 cigarettes daily wants highly effective contraception but does not want an oestrogen-containing method. Which option best meets that request?

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Correct answer: E — An LNG-IUD with separate smoking-cessation support

The best answer is “An LNG-IUD with separate smoking-cessation support”. An LNG-IUD provides highly effective, reversible contraception without oestrogen and is not restricted merely because the patient smokes. At age 35 or older, smoking makes CHC less suitable or contraindicated depending on cigarette consumption. Smoking-cessation support remains important but should be offered alongside, rather than as a precondition for, effective contraception.

Reference: CoSRH, UK Medical Eligibility Criteria for Contraceptive Use 2025: https://www.cosrh.org/Common/Uploaded%20files/documents/UKMEC_2025.pdf