Contraception

Question 1

Name 9 types contraception and list them according to efficacy from least to most effective using Pearl index.

Answer 1

1. Calendar method
2. Withdrawal
3. Barrier methods:
   • cervical caps
   •Sponge
   • female condom
   • male condom
   • diaphragm
4. Progestogen only pills or breastfeeding
5. Combined oral contraceptives, patch and vaginal ring
6. Injectable
7. Intrauterine devices
   • copper containing
   • progestogen containing
8. Sterilization
9. Implantable

Question 2

Name 8 benefits of oral contraceptives

Answer 2

• prevent pregnancy
• relieve dysmenorrhea
• decrease ovarian cysts
• treat acne
• control menstrual cycle and treat menorrhagia ( heavy bleed)
• less anemia
• decrease PMs symptoms
• reduce risk endometrial and ovarian cancer

Question 3

Name 8 risks oral contraceptives

Answer 3

• VTE
• very slight increase risk breast cancer
• increased risk CVA (cerebrovasular accident)
• increased risk mi smokers >35
• depression
• liver adenomas (very rare)
• breast tender
• migraine/ headache

Question 4

Name 10 absolute contraindications coc

Answer 4

• Pregnancy
• thromboembolic disease
• oestrogen dependant tumours
• coronary/cerebrovascular disease
• uncontrolled ht
• smoker > 35
• migraine with neurological symptoms
• liver disease
• Vaginal bleeding without diagnosis
• uncontrolled hyperlipidaemia

Question 5

Which IUD is more effective?

Answer 5

Levonogestrol (progestogen containing)

Question 6

Compare copper to progestogen containing IUDs. (5)

Answer 6

• Increased menstrual flow vs less
• increased dysmenorrhea vs less
• increased incidence PID vs less
• increased risk ectopic pregnancy vs none.
• less effective vs more.

Question 7

Name 5 emergency contraception methods

Answer 7

• Yuspe method ( combination oestrogen progestin ECP: ethanyl estradiol and levonorgestrel
. Progestin-only ECP (levonorgestrel)
• copper containing IUCD
• mifepristone (antiprogesterone)
• ulipristal acetate (selective progesterone r modulator)

Question 8

How does yuspe method emergency contraceptive work and how effective is it? (5)

Answer 8

• Combination ethinyl estradiol and levonorgestrel.
• 2 doses of both 100 micrograms ee and 0,50 LNG taken 12 hours apart.
• risk nausea vomiting, if vomit within 2 hours repeat dose.
• take within 72 hours preferably.
• 2% unsuccessful

Question 9

How does progestin-only ECP work and how effective is it? (4)

Answer 9

• Levonorgestrel - prevent implantation by uterine contraction
• 2 doses 0,75 mg 12 hours apart. Less side effects.
• take within 120 hours.
• 1-2% unsuccessful

Question 10

How does copper containing IUCD emergency contraception work and how effective is it?

Answer 10

• Insert within 5 days unprotected sex

* most effective- less than 1% unsuccessful

Question 11

How does mifepristone emergency contraception work? (3)

Answer 11

• Antiprogesterone
• single dose
• prevent ovulation during follicular phase and prevent endometrial development

Question 12

How does ulipristal acetate emergency contraception work? (3)

Answer 12

• Single dose take within 120 hours
• selective progesterone receptor modulator
• prevent/ delay ovulation.