Contraception 2

Question 1

When should you start oral hormonal contraception?

Answer 1

Day 1 of natural (no extra precautions needed)

Question 2

What is Quick starting?

Answer 2

When you start OC on day 6 or later (additional precautions needed for 7 days for COC and 2 days for POC)

Question 3

How many days are extra precautions needed when changing from POP to Qlaira (COC)?

Answer 3

9 days

Question 4

How many days are extra precautions needed when changing from POP to Zoely (COC)?

Answer 4

7 days - most POP to COC 7 days

Question 5

How many days are extra precautions needed when changing from COC to POP?

Answer 5

ensure previous contraception taken effectively or exclude pregnancy; use additional precautions for 2/7, if pill-free period

Question 6

How many days are extra precautions needed when changing from COC (ED) to POP?

Answer 6

– use addition precaution for 2/7, if ED/placebo pills taken

Question 7

How many days are extra precautions needed when changing from COC (non-ED) to POP?

Answer 7

for immediate cover, omit pill-free period, start POP immediately

Question 8

What is a form of non-hormonal emergency contraception?

Answer 8

Cu-IUD

Question 9

What oral emergency hormonal contraceptions are available?

Answer 9

Levonelle or EllaOne

Question 10

What is Levonelle?

Answer 10

(LNG) levonorgestrel 1.5mg (Levonelle® 1500 [POM], Levonelle One Step®)

Question 11

What is EllaOne?

Answer 11

(UPA) – ulipristal acetate 30mg (ellaOne® [POM])

Question 12

Kourtney takes Logynon ED. She missed her pills only on day 1, 14 and 24 and had sexual intercourse on day 25. Does she need EHC?

Answer 12

no – 7 days’ worth of cover after day 1, built up cover. Missed one at day 14 but hasn’t missed 2 in a row and hasn’t had sex. Day 24 is a placebo pill so doesn’t make a difference

Question 13

What is affected by Enzyme drugs + Griseofulvin

Answer 13

o Patches, vaginal rings, oral tablets, implant
 Antiepileptics: Carbamazepine, oxcarbazepine, phenytoin, phenobarbital, primidone, topiramate
 Antiretrovirals: Nevirapine, ritonavir
 Antibiotics: Rifabutin, rifampicin
 Other: St John’s Wort and griseofulvin
 INCLUDING 28 DAYS AFTER CESSATION

Question 14

What are NOT affected by enzyme inducing drugs?

Answer 14

Parenteral POC, IUS* (BNF p760)

Question 15

What risks are associated with sodium valproate?

Answer 15

• Valproate: epilepsy or bipolar disorder
• Serious risk from taking valproate in pregnancy
o Congenital malformation and neurodevelopmental disorders
• Specialist initiation
• Requires HIGHLY effective contraceptive option (LARC or any with failure rate of <1%), and if not, implement regular pregnancy testing
• ALL female patients of child-bearing age, regardless of sexual activity
• Give patient card, patient guide, and complete Annual risk Acknowledgement form