Contraception

Question 1

What is combined contraception ?

Answer 1

These are short acting estrgoen and progesterone combined cotraception given as pills, path or ring.

Question 2

what are the types of progesterone only contraception ?

Answer 2

Short acting = POP
Long acting= Levnorgestral IUS.

Question 3

What are the non-hormonal short acting contraceptions ?

Answer 3

Condoms, diaphragm, Fertility awareness method

Question 4

What is the non-hormonal long acting contraception ?

Answer 4

Cooper IUD.

Question 5

What is the permanent non-hormonal contraception?

Answer 5

Tubal ligation and vasectomy.

Question 6

What are the no use failure contraception choices ?

Answer 6

Subdermal Implant
Progesterone Intra uterine system
Copper Intra uterine device
Depo injection (progesterones)
Sterilisation

Question 7

What are the use failure contraception choices ?

Answer 7

*POPs and COCs
*Vaginal ring and Patch both (Oestrogen/Progesterone).
Condoms, Diaphragm (mainly Caya) and withdrawal

Question 8

What is the calender method of contraception?

Answer 8

To get the first day of fertile period subtract 18 from the total days of the shortest cycle.
To get the last day of fertile period subtract 11 from the total days of the longest cycle.

Question 9

What is the MOA of OCPS ?

Answer 9

Estrogen inhibits mid-cycle LH surge
Prevents ovulation
Progestins alters cervical mucus and endometrium
Less permeable + inhibits implantation
Efficacy = 99% when used correctly
Fixed dose and Triphasic

Question 10

what are the benifits of OCPs ?

Answer 10

-Reduced menstrual blood loss
-Decreased severity of dysmenorrhea/endometrisosis
-Improved acne generally
- Reduction of Functional ovarian cysts, Ectopic pregnancy , Breast cysts, PID, Ovarian and endometrial CA.

Question 11

What are the contraindications for OCPs?

Answer 11

BMI >35
Smokers>35
All women >50
Family Hx of thrombophilia/VTE (UKMEC4)
Existing atheroscleromatous heart disease

Question 12

What are the absolute contraindications for OCPs ?

Answer 12

DM
Vascular headaches
HTN
Sickle cell disease
Uterine leiomyoma (fibroids)
Smoking
Seizure disorder
Imminent elective surgery

Question 13

What are the contents of weekly CONTRACEPTIVE PATCH?

Answer 13

150micrograms norelgestromin
20micrograms ethinyl estradiol

Question 14

What are the features of combined estrogen/progestin Nuvaring?

Answer 14

It can be inserted by the patient and has effect for 3 weeks + 1 ring free week.

Question 15

What are the pill taking regimens ?

Answer 15

• Standard = 21 active pills or 1 ring or 3 patches and 7 days of HFI.
• Shortened HFI regimen= 21 active pills or 1 ring or 3 patches and 4 days of HFI.
• Extended ( tricyclic)= 9 weeks( 3 x 21 active pills or 3 rings or 9 patches and 4 or 7 days of HFI.
• Flexible extended = continued use of more than 21 days of active pills, rings or patches until brekthrough bleeding occurs followed by 4 days of HFI.
• Continues use without HFI.

Question 16

What are the advantages of progestin only pills ?

Answer 16

• Everyday pill taking regimen with 99% efficacy.
• It is safe in patients with oestrogen contraindictaion.
  *Suitable for lactating women for 30 days postpartum and those with Migraine with aura.
• Safe upto 55 years of age.
• May cause weight gain and fluid retention.

Question 17

What is Depro-provera injection ?

Answer 17

It is an IM progestin only injection given every 12 weeks. Increased risk of BMD reduction and delayed return of menses upto 12 months.

Question 18

What is progestin only skin implant ?

Answer 18

It is a skin implant with only 0.05% failure and provide contraception for 3 years.

Question 19

What are the efficacies of different Levonorgestral IU systems?

Answer 19

52 mg 8 years, 19.5 mg 5 years and 13.5 mg 3 years.

Question 20

What is IUB ballerien ?

Answer 20

It is an itrauterine baloon copper based contraceptive that provides contraception for 5 years.

Question 21

What is the efficacy of 3 day porgestin only pill for emergency contraception ?

Answer 21

first 24 hours post sex = 95%
24 to 48 hrs= 85%
48-72 hrs= 58%

Question 22

What is the copper coil (IUD) for emergency contraception?

Answer 22

The copper coil can be fitted as emergency contraception up to 5 days after unprotected sex or up to 5 days after the earliest date of ovulation, whichever is earlier.