Contraception

Question 1

Action of levonorgestrel

Answer 1

Stops ovulation and inhibits implantation

Question 2

Types of emergency contraception:

Answer 2

Levornorgestrel
Ulipristal (EllaOne)
Copper IUD

Question 3

In what time frame should each emergency contraception be used?

Answer 3

Levonorgestrel - within 72 hours of UPSI
Ulipristal - within 120 hours of UPSI
Copper IUD - within 5 days of UPSI or 5 days after likely ovulation date

Question 4

When can you provide contraceptive, abortion and STI advice and tx to young people under 16?

Answer 4

-They understand all aspects of the advice and its implications
-You cannot persuade the young person to tell their parents or to allow you to tell them
-In relation to contraception and STIs, the young person is very likely to have sex with or without such treatment
-Their physical or mental health is likely to suffer unless they receive such advice or treatment, and
-It is in the best interests of the young person to receive the advice and treatment without parental knowledge or consent

Question 5

What age would trigger child protection measures in the context of a sexual health consultation?

Answer 5

Under the age of 13 - considered unable to consent for sexual intercourse

Question 6

When switching from copper IUD to COCP what is the guidance?

Answer 6

If copper IUD is removed in days 1-5 of cycle, COCP can be commenced immediately and no further measures needed
If coil removed and COCP started from day 6 then barrier contraception for 7 days

Question 7

What contraception is suitable for transgender males (female at birth) who are on testosterone therapy? And why is contraception important?

Answer 7

Copper intrauterine device - non hormonal so won’t interact with testosterone regime, however make sure pt is aware it can worsen menstrual bleeding
Testosterone therapy does not have contraceptive effects and if the pt becomes pregnant testosterone is contraindicated as it can have teratogenic effects