contraception

Question 1

COCP- Mechanism

Answer 1

Inhibit ovulation

Question 2

COCP missed pill rules:

Answer 2

1 pill = take asap and no additional precaution

2 Missed pills:

Day 1-7 - if UPSI in pill free interval = emergency contraception

Day 8-14 - no need for emergency

Day 15-21 - Omit pill freePOP

Question 3

POP missed pill rules (cerazette = desogestrel)

Answer 3

If less than 12 hours take and continue as normal

If >12 hours hours take asap and extra precaution 48 hours,

take the missed pill as soon as possible. If more than one pill has been missed just take one pill. Take the next pill at the usual time, which may mean taking two pills in one day
continue with rest of pack
extra precautions (e.g. condoms) should be used until pill taking has been re-established for 48 hours

Question 4

Mechanism of action of POP (not desogestrel)

Answer 4

Thickens cervical mucus

Question 5

Mechanism of action of POP (Desogestrel/cerazette)

Answer 5

Inhibits ovulation
Thickens cervical mucus

Question 6

Mechanism of action of Injectable?

Answer 6

Inhibits ovulation
Thickens cervical mucus

Question 7

Mechanism of action of implant?

Answer 7

Inhibits ovulation
Thickens mucus

Question 8

Mechanism of action of intrauterine copper coil?

Answer 8

Decreases sperm mobility and survival

Question 9

Mechanism of action of IUS?

Answer 9

Prevnts endometrial proliferation
Thickens mucus

Question 10

When can you use levonorgestrel / ullipristal?

Answer 10

Levonorgestrel (72hours)
Ullipristal (120hours)

Inhibits ovulation

Question 11

Copper coil for emergency?

Answer 11

Up to 5 days (toxic to sperm and stops implantation)

Question 12

How long for a mirena to work if not fitted on day 1?

Answer 12

7 days

Same for COCP, Implant, Injection

Question 13

Which contraception is most linked to weight gain?

Answer 13

Depo

Question 14

Condom if latex allergy?

Answer 14

Polyurethane

Question 15

COCP and post partum

Answer 15

Need to wait 21 days due to increased risk of VTE

Question 16

COCP and cancers?

Answer 16

Increased risk of breast and cervical

Decreased risk of endo / ovarian

Question 17

Patch rules?

Answer 17

If contraceptive patch change is delayed by >48hours, change it now and use barrier for 7 days

Question 18

Vomiting and levonogestrel?

Answer 18

If vomiting occurs within 3 hours of ingestion then repeat the dose

Question 19

When can you start hormonal contraception following levonorgestrel?

Answer 19

Immediately

Question 20

COCP and breastfeeding?

Answer 20

UKMEC 4 if breastfeeding and <6/52 post partum

Question 21

Traditional POP missed rules ? (e.g. Micronor)

Answer 21

<3 hours = fine

> 3hours = condoms until 48 hours established

Question 22

Paralysed and COCP?

Answer 22

UKMEC3

Question 23

Progesterone pill and Abx

Answer 23

No additional precautions

Question 24

Nexplanon after emergency contraception?

Answer 24

put it in immediately

Question 25

UKMec 4 cocp

Answer 25

Migraine with aura Breastfeeding <6 weeks post-partum Age 35 or over smoking 15 or more cigarettes/day Systolic 160mmHg or diastolic 95mmHg Vascular disease History of VTE Current VTE (on anticoagulants) Major surgery with prolonged immobilisation Known thrombogenic mutations Current and history of ischaemic heart disease Stroke (including TIA) Complicated valvular and congenital heart disease Current breast cancer Nephropathy/retinopathy/neuropathy Other vascular disease Severe (decompensated) cirrhosis Hepatocellular adenoma Hepatoma Raynaud's disease with lupus anticoagulant Positive antiphospholipid antibodies