A woman using a COC containing 30 microgram Ethinylestradiol develops persistent breakthrough bleeding after 3 months of use. STI screening is negativ...

Question

A woman using a COC containing 30 microgram Ethinylestradiol develops persistent breakthrough bleeding after 3 months of use. STI screening is negative and pregnancy is excluded. What is the most appropriate next step?

Accepted Answer

Switch to a COC containing a different progestogen

Answer

Increase the Ethinylestradiol dose to 50 micrograms

Answer

Investigate with a pelvic ultrasound as the first step

Answer

Stop the COC permanently

Answer

Reassure only; no change is needed after 3 months

uk-dfsrh MCQ (SBA): CHC Breakthrough Bleeding Management

A woman using a COC containing 30 microgram Ethinylestradiol develops persistent breakthrough bleeding after 3 months of use. STI screening is negative and pregnancy is excluded. What is the most appropriate next step?