skip to main content

Repeat UPSI after LNG EC — DFSRH MCQ

Instant feedback + full explanation. One question, done properly.

HardEmergency contraceptionRepeat UPSI after LNG ECDFSRH

A 20-year-old took levonorgestrel EC 4 days ago after UPSI and had further UPSI yesterday. She has not started regular contraception and is on cycle day 16 of a 28-day cycle. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: A — Offer Cu-IUD and assess repeat oral EC if declined

The best answer is “Offer Cu-IUD and assess repeat oral EC if declined”. Levonorgestrel EC taken four days earlier does not provide ongoing protection for later unprotected intercourse. A copper IUD is the most effective option and may cover multiple recent episodes if its timing criteria are met. If it is declined, repeat oral EC should be assessed rather than assumed unnecessary; a pregnancy test today is too early to exclude conception from the recent intercourse.

Reference: CoSRH/FSRH, Emergency Contraception (amended July 2023): https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-guideline-emergency-contraception03dec2020-amendedjuly2023-11jul.pdf