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Barrier Methods — DFSRH MCQ

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EasyBarrier MethodsDFSRH

A 31-year-old woman uses a latex diaphragm with spermicide as her sole contraceptive method. She has uncomplicated vulvovaginal candidiasis and is advised to use a single application of clotrimazole 10% internal vaginal cream tonight. Her symptoms resolve within 48 hours, and she plans vaginal intercourse 72 hours after treatment. Which contraceptive advice is most appropriate?

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

Reveal the answer and explanation

Correct answer: E — Use alternative contraceptive precautions until at least 5 days after the clotrimazole application

Explanation lettering: D = shown as C · E = shown as D · C = shown as E

Clotrimazole internal vaginal cream can damage latex contraceptives, reducing their mechanical reliability. This interaction applies to latex diaphragms as well as latex condoms. The product information therefore advises alternative contraceptive precautions for at least 5 days after treatment. Although this woman's symptoms have resolved, intercourse at 72 hours remains within that interval, so her diaphragm should not be relied upon. A is incorrect because the warning expressly includes diaphragms. B incorrectly links contraceptive reliability to symptom resolution; the relevant interval is measured from use of the clotrimazole preparation. D does not solve the problem because a newly supplied latex diaphragm could still be exposed to residual product during the 5-day interval. E substitutes another latex barrier that may likewise be damaged and therefore does not provide a reliable alternative. A compatible non-latex method or abstinence could be used during the interval. Vaginal intercourse should also be avoided while infection is present and during use of the product because of possible transmission to the partner.

Reference: Canesten Thrush Internal Cream 10% w/w vaginal cream — Summary of Product Characteristics (11 November 2025) — https://www.medicines.org.uk/emc/product/8223/smpc