Emergency contraception (EC) prevents pregnancy after unprotected sex — it is not an abortion pill. EC pills work primarily by delaying or preventing ovulation. They cannot terminate an established pregnancy. The copper IUD may prevent implantation if taken after fertilisation has occurred, but this is distinct from termination of pregnancy. EC is a safe and legal method of contraception available from pharmacies, sexual health clinics, and GPs without prescription in most UK settings.

Yes, but with important caveats. ellaOne (ulipristal acetate) inhibits progesterone receptors — the same mechanism used by hormonal contraceptives to prevent ovulation. If you restart hormonal contraception immediately after taking ellaOne, it may reduce ellaOne’s efficacy. You should wait at least 5 days after taking ellaOne before restarting hormonal contraception. During this 5-day window, use barrier contraception. Levonorgestrel (Levonelle) does not interact with hormonal contraception in the same way, so you can restart your normal pill immediately after taking it.

Yes. Emergency contraception is safe to take more than once — including multiple times in the same menstrual cycle — with no lasting health effects. However, it should not be used as a regular contraceptive method because it is less effective than routine contraception and does not protect against STIs. Repeated need for EC is a clear signal to discuss a more reliable long-term method. There are no restrictions on how often EC can be used, though the efficacy of the EC pill decreases with time, and the copper IUD retains full efficacy regardless of the number of insertions.

Yes. Hypertension in pregnancy — particularly pre-eclampsia (hypertension with proteinuria after 20 weeks) — is a serious condition affecting 2–5% of pregnancies. It can cause maternal complications (seizures, stroke, organ failure) and fetal growth restriction or preterm birth. Safe antihypertensives in pregnancy include labetalol, nifedipine, and methyldopa. ACE inhibitors and ARBs must be avoided in pregnancy due to fetal toxicity. Women with pre-existing hypertension should have their medication reviewed before or at the start of pregnancy.

The most common causes of bilateral ankle swelling are venous insufficiency (varicose veins and poor venous return), medications (particularly calcium channel blockers such as amlodipine), and inactivity. Heart failure is an important cause that must be excluded, particularly if accompanied by breathlessness. Bilateral swelling is rarely DVT — DVT almost always affects one leg at a time. If both ankles swell consistently at the end of the day and improve overnight, venous insufficiency and medication side effects are the most likely explanations.

Post-thrombotic syndrome (PTS) is a complication affecting 20–50% of people after DVT, causing chronic pain, swelling, skin changes, and — in severe cases — venous ulceration in the affected leg. It results from valve damage in the deep veins caused by the clot. The most effective prevention is wearing correctly fitted class 2 graduated compression stockings for at least 2 years after DVT. Early ambulation after DVT (walking is safe and beneficial), adequate anticoagulation, and compression therapy all reduce the risk. Severe PTS may require specialist vascular assessment.

Lymphoedema is chronic, progressive swelling caused by damage to the lymphatic system. Unlike pitting oedema from venous causes, lymphoedema is typically non-pitting, affects the foot and toes (not just the ankle), and does not improve with overnight elevation. Common causes include cancer treatment (lymph node removal or radiotherapy), infection (particularly recurrent cellulitis), and primary lymphatic abnormalities. It is managed — not cured — with complex decongestive therapy (manual lymphatic drainage, compression garments, skin care, and exercise). Early specialist referral to a lymphoedema clinic is important.

Familial hypercholesterolaemia (FH) affects 1 in 250 people in the UK and causes very high LDL cholesterol from birth due to a genetic mutation. It is severely underdiagnosed — only 8% of those with FH in the UK have been identified. Diagnostic clues include very high total cholesterol (above 7.5 mmol/L in adults), a family history of early heart attack (under 60 in a first-degree relative), physical signs (xanthelasma, corneal arcus), or a personal history of early cardiovascular disease. DNA testing can confirm the mutation. Treatment is high-intensity statins from diagnosis, with PCSK9 inhibitors if needed.