Contraception

Question 1

Contraceptives: time till effective (if not the first day of period).
- IUD (1)
- POP (1)
- others (1)

Answer 1

instant: IUD
2 days: POP
7 days: COC, injection, implant, IUS

Question 2

Emergency contraceptives:
When to avoid EllaOne (uliprisatal) (1)

Answer 2

asthma

Question 3

Nexplanon (estronogestrel):
where inserted?

Answer 3

subdermal

Question 4

COCP and surgery:
when to stop (1)

Answer 4

4 weeks before
Mitch to progesterone only

Question 5

COCP:
UKMEC 4 criteria

Answer 5

more than 35 years old and smoking more than 15 cigarettes/day
migraine with aura
history of thromboembolic disease or thrombogenic mutation
history of stroke or ischaemic heart disease
breast feeding < 6 weeks post-partum
uncontrolled hypertension
current breast cancer
major surgery with prolonged immobilisation
positive antiphospholipid antibodies (e.g. in SLE)

Question 6

Contraceptive side effects:
osteoporosis (1)
weight gain (1)

Answer 6

DEPO for both (and delayed return to fertility)

Question 7

Anti-epileptics and contraception:
- phenytoin,carbamazepine, barbiturates, primidone, topiramate, oxcarbazepine (3)
- lamotrigine (1)

Answer 7

The pills are the problem
Coil/ Depo good for all

UKMEC 3: the COCP and POP
UKMEC 2: implant
UKMEC 1: Depo-Provera, IUD, IUS

For lamotrigine:
UKMEC 3: the COCP
UKMEC 1: POP, implant, Depo-Provera, IUD, IUS

Question 8

POP late:
what to do? (1)
which is the exception to this rule (1)

Answer 8

Traditional’ POPs (Micronor, Noriday, Nogeston, Femulen)
-If less than 3 hours late > no action required, continue as normal.

Cerazette (desogestrel)
-If less than 12 hours late > no action required, continue as normal

Question 9

Which contraception contraindicated >50?

Answer 9

DEPO (osteoporosis)

Question 10

Mechanism of action:
- POP (other than desogestrol)
- desogestrel-only
- injectable
- IUS
- levonorgestrel
- IUD
- implant
- COCP

Answer 10

POP (EXCEPT desogestrel): thickens cervical mucus

IUS: prevents endometrial proliferation
IUD: toxic to ovum and sperm

THE REST STOP OVULATION.

Question 11

COCP and postpartum - when to avoid

Answer 11

breast feeding < 6 weeks post-partum= UKMEC 4

Question 12

stroke / IHD + COCP

Answer 12

UKMEC 4

Question 13

current breast cancer contraceptive

Answer 13

only IUD

Question 14

Cerazette (desogestrel) - why special

Answer 14

POP with 12hr window

Question 15

Fraser gudeliens_ what ages

Answer 15

<13= ILLEGAL
13-15= Fraser
16+= allowed