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Revision aid, not clinical advice. This page is educational material written for exam preparation. It is not a substitute for the current guideline or for clinical judgement, and must not be relied on for the care of any individual. Always check up-to-date national guidance and verify independently before acting on anything here.
The UKMEC Reasoner
Contraception eligibility is reliably tested and reliably muddled. Instead of looking the table up, you’ll reason your way to the category the way an exam answer expects — is there oestrogen? is this a clotting or vascular flag? — then test yourself on the grid in At a glance. Categories are drawn from UKMEC 2025 (CoSRH, December 2025). Revision aid, not clinical advice — always check the current guideline before treating real patients.
Understand mode: the mental model behind the four categories — tap a card to see why it exists.
The one idea · a UKMEC number is a safety verdict
Every UKMEC number is just a safety verdict on one method, for one person, with one condition. It answers a single question: given this condition, how risky is this method? It says nothing about how well the method works — UKMEC is about safety, not efficacy. Learn the four verdicts below and most questions answer themselves.
Tap any card to see why that verdict exists and what it means in an exam answer.
Two rules the exam loves
UKMEC is about safety, not efficacy — and the numbers are not simply additive on paper, but several Category 2s can add up to meaningful cumulative risk, while several Category 3s may together be unacceptable.
Starting a method
The category for someone beginning this method now, with this condition already present.
Someone already on it
The category for someone already using the method who then develops the condition. It can be higher — exam questions often test this split (IHD, migraine, stroke).
Initiation (starting a method) and continuation (someone already on it who develops the condition) can differ — the Reason tab lets you switch between both.
Pick a woman’s condition, then work actively to the category for each method — a guiding question first, then commit your answer, then see the clinical reasoning. This is thinking through the case, not looking it up.
The combinations the exams keep testing, as free-recall flashcards. Think of the answer, reveal, then rate how it went — the tool schedules each card so the ones you find hard come back soonest.
At a glance · the eligibility grid
Every condition in this tool against all six methods, colour-coded by UKMEC category. Tap any cell for why it’s scored that way; switch on Test me to quiz yourself; tap a colour in the key to spotlight the pattern; or tap a method / condition heading for a rule of thumb.
For revision: what the guideline says for this practice scenario — not for use with a real patient.
Categories are drawn from UKMEC 2025, for revision only. “timing” = governed by timing (e.g. coils postpartum), not a fixed category; “no rating” = UKMEC issues no category at all (sickle cell trait).
The mental model · anchor on oestrogen, then work outwards
Almost every Category 4 is a combined (oestrogen-containing) method meeting a clotting or vascular risk. When a stem lists a cardiovascular or thrombotic flag, your reflex is “no oestrogen” — and the copper coil becomes the reliable safe harbour. The combinations that come up again and again:
- Migraine with aura — CHC Category 4 at any age. New aura on the pill → CHC becomes Category 4.
- Smoking and 35+ — ≥15/day is Category 4; fewer than 15/day or stopped less than a year ago is 3; stopped a year or more is 2, whether starting or continuing.
- Current breast cancer — every hormonal method is Category 4; only the copper coil is unrestricted.
- Enzyme inducers (carbamazepine, rifampicin, St John’s Wort) — UKMEC 2025 gives them no category; the FSRH drug-interactions guidance (May 2022) says the injection and both coils are unaffected, while CHC, the POP and the implant are not advised during use and for 28 days after.
- Initiation vs continuation — IHD, stroke and migraine step up once she’s already on the method.
- Postpartum timing — weeks since delivery and whether she’s breastfeeding decide it.
Anchor on oestrogen, then ask “starting or continuing?”
When a stem lists a cardiovascular or thrombotic flag, your reflex should be “no oestrogen”, and the copper coil becomes your reliable safe harbour. For the diploma, add one more reflex: ask whether she’s starting or continuing — that’s where the extra marks hide.
Go further
Create a free account to see what else Core Revision offers for your exam. The tool stays free either way.
Take this further
This tool is free. If you are preparing for the DCSRH, the full course puts the same reasoning into exam-style questions: a question bank with Core Lens and Deep Dive explanations, a Core Calendar revision plan built around your exam date, and Core Compass to show you which topics need you next.
Preparing for the MRCGP AKT instead?
Questions? Email admin@corerevision.com
Based on UKMEC 2025 (College of Sexual & Reproductive Healthcare, December 2025). A revision aid — always check the full guideline for real clinical decisions.
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Core Revision Ltd is an independent educational platform and is not affiliated with the RCGP or the College of Sexual & Reproductive Healthcare (CoSRH).
Written by practising UK GPs for exam revision. Sources are cited on this page and corrections are logged. Education only — always confirm against current guidance. Core Revision is an independent revision resource.