Contraception

Question 1

Mode of action of:
- COCP, POP, Injectable, Implantable, IUD, IUS

Answer 1

COCP: Inhibits ovulation
POP: Thickens mucus
Desogestrel only, Injection, Implant: Inhibits ovulation (and thickens mucus)
IUD: kills sperm
IUS: prevents endometrial proliferation

Question 2

Time until each contraceptive is effective

Answer 2

Instant: IUD
2 days: POP
7 days: Others

Question 3

Missed pill rules for COCP

Answer 3

1 missed pill: take pills and no additional contraception
2 missed pills: take pills and 7 day barrier protection
- week 1: emergency
- week 3: omit pill free period

Question 4

How long before surgery do you stop the COCP

Answer 4

4 weeks

Question 5

Which cancers does the COCP increase and decrease risk

Answer 5

Increases risk of BREAST and CERVICAL
Decreases risk of OVARIAN and ENDOMETRIAL

Question 6

Which contraceptive is the most effective?

Answer 6

Implant

Question 7

Common SE of the implant and treatment

Answer 7

Unscheduled bleeding
Prescribe 3m of COCP

Question 8

Where is the implant placed

Answer 8

Subdermal in non-dominant arm

Question 9

Switching from:
- IUD to COCP
- POP to COCP

Answer 9

IUD to COCP: no additional protection if removed ay 1-5 of cycle
POP to COCP: 7 day barrier protection

Question 10

Missed pill rules for the POP

Answer 10

Traditional: 3 hours late
Desofestrell (cerazette): 12 hours late

take missed pill and continue pack
barrier protection for 48 hours

Question 11

Do you need extra protection when on Abx for POP?

Answer 11

No

Question 12

Counsel a lady on how to apply the patch

Answer 12

1 patch every 3w then 1w break
48 hours late changing the patch then barrier for 7 days

Question 13

2 side effects of the injection

Answer 13

increases weight and increased return to fertility

Question 14

what age should you stop the injection

Answer 14

50

Question 15

how often is the injection needed

Answer 15

every 12 weeks

Question 16

Can you use oral contraceptives after a gastric bypass

Answer 16

no

Question 17

do males on female hormones need contraception

Answer 17

yes - sperm are still alive

Question 18

how effective is lactational amenorrhoea

Answer 18

98% if fully breastfeeding up to 6m

Question 19

POP postpartum

Answer 19

start anytime, 2 day barrier if starting after 21 days

Question 20

COCP postpartum

Answer 20

Start after 21 days with 7 days barrier
UKMEC2 6w-6m
UKMEC 4 if breastfeeding

Question 21

IUD postpartum

Answer 21

In 48 hours or after 4 weeks

Question 22

Which is the most effective form of emergency contraception and when can it be used

Answer 22

IUD
Within 5 days or 5 days after ovulation

Question 23

MOA and trade name of Levonorgesterol

Answer 23

Stops ovulation and inhibits implantation
Levonelle

Question 24

MOA and trade name of Ulipristal

Answer 24

Inhibits ovulation
ELLAONE

Question 25

Dosages of Levonelle and Ellaone

Answer 25

Levonelle: 1.5mg (double if BMI above 26 or weight above 70kg, repeat dose if vomit in 3 hours)
Ellaone: 30mg

Question 26

When is Ellaone and Levonelle effective

Answer 26

Ellaone: within 120 hours
Levonelle: within 72 hours

Question 27

When can you start hormonal contraception after Ellaone and Levonelle

Answer 27

Ellaone: in 5 days (1w break if breastfeeding)
Levonelle: immediately

Question 28

Which emergency contraception needs caution in asthma

Answer 28

Ellaone (ulipristal)

Question 29

Give 1 absolute contraindication to the IUD

Answer 29

PID

Question 30

When in the cycle should the IUD be inserted

Answer 30

Any stage

Question 31

UKMEC

Answer 31

UK Medical Eligibility Criteria
(learn them lol)