Contraception

Question 1

Condoms

Answer 1

Barrier method.

Low success rate, used wrongly, do protect against STIs.

Question 2

COCP

Answer 2

Inhibits ovulation. Lighter less painful periods.
Start < day 5- immediate. If after day 5 then condoms for 7 days.
Missed 1 pill- take ASAP.
Missed > 2 pills- take ASAP then condoms until 7 pills in a row taken. If in week 1- emergency contraception.
If in week 2- condoms until 7 days back on pill.
If in week 3- do back to back pack.
Side effects: VTE, breast and cervical cancer. Reduces risk of ovarian and endometrial cancer.

Question 3

CI to COCP

Answer 3

Absolute UKMEC4: 
Breast feeding < 6 weeks postpartum.
> 35 yrs and smoke > 15/day
History of VTE, stoke, ischemic HD
Migraine with aura
Uncontrolled hypertension
Current breast caner.
Major surgery with immobilisation.
Diabetes for > 20 years.

Pretty bad UKMEC3:
> 35 years, smoke < 15/day
BMI > 35
FH of thromboembolic disease
Controlled hypertension
BCRA gene carrier
Current gall bladder disease

Question 4

POP

Answer 4

Thickens cervical mucus.
If taken < day 5 immediate, if after day 5 use condoms for 2 days. Take at same time every day (within 3 hours). Missed pill- take ASAP and condoms for 2 days.
Side effects: irregular bleeding.

Question 5

Injection

Answer 5

Progesterone only.
Inhibits ovulation and thickens cervical mucus. Lasts 12 weeks.
Side effects: weight gain.

Question 6

Implant

Answer 6

Progesterone only.
Inhibits ovulation and thickens cervical mucus. Lasts 3 years.
Side effects: irregular bleeding.

Question 7

IUD

Answer 7

Copper coil. Decreases sperm motility and survival.

Side effects: heavy periods.

Question 8

IUS

Answer 8

Prevents endometrial proliferation and thickens cervical mucus. Lasts for 5 years.
Side effects: irregular bleeding.

Question 9

Post partum

Answer 9

Start POP anytime, after day 21, additional contraception for first 2 days.

COCP- absolutely contraindicated if breastfeeding and < 6 weeks post partum.

IUD or IUS can be inserted within 4 hours of birth or after 4 weeks.

Question 10

Emergency contraception

Answer 10

Levonorgestrel- inbits ovulation. Taken ASAP < 72 hours. If vomit < 3 hours then repeat dose.
Ulipristal/EllaOne- < 120 hours. Can reduce effectiveness of contraception.

IUD insertion- within 5 days. 99% effective.