12. Do you have asthma?

The FSRH states that UPA may be less effective for a woman who has severe asthma managed with oral glucocorticoids. 

13. Are you breastfeeding?

UPA is excreted in breast milk and the safety of using UPA during breastfeeding has not been studied. The summary of product characteristics for UPA advises that breastfeeding should be avoided for one week after use and that milk should be expressed and discarded during that time. The use of LNG is not contraindicated during breastfeeding.

14. Did you know that some oral EC methods may be less effective in heavier women?

It is possible that a weight greater than 70kg or BMI greater than 26kg/m2 could reduce the effectiveness of oral EC, particularly LNG.

The FSRH recommends that either UPA or, if the PGD allows it, a double dose (3mg) of LNG is given in this situation. Women should be informed that the effectiveness of the Cu-IUD is not known to be affected by weight or BMI.

Body weight is a sensitive issue for many women and so phrasing this in a sensitive manner is important.

If the customer does not meet one or more of these criteria, EC should not be supplied and she should be referred to a doctor or sexual health clinic.