Contraception

Question 1

POP

Answer 1

CI: undiagnosed PV bleeding, forgetfullness
How it works: preventing implantation of egg in womb
Treatment course: every day
S.E.: hormonal, erratic periods,
+ve/-ve: take tablet daily at same time
Extras: start on day 1 of cycle, if >3hrs use condom for 1 week

Question 2

Mirena

Answer 2

CI: undiagnosed PV bleeding, gynae Ca, PID in last 3 months
How it works: preventing implantation of egg in womb
Treatment course: 3/5 years
S.E.: local infection, perf, avulsion, movement
+ve/-ve: can forget about it, long term, fertility returns once removed, ligter/absent periods
Extras: trained nurse / dr can insert in GP, OPC, GUM, f/u 3-6 weeks, >45 y/o can stay in until menopause

Question 3

Implant

Answer 3

CI: undiagnosed PV bleeding
How it works: preventing implantation of egg in womb
Treatment course: 3 yrs
S.E.: pain, infection, scar at site, can feel it,
+ve/-ve: can forget about it, lighter/absent periods
Extras: 4cm long, LA injection to numb area

Question 4

Injection

Answer 4

CI: undiagnosed PV bleeding
How it works: preventing implantation of egg in womb
Treatment course: 3 months
S.E.: weight gain, osteoporosis,
+ve/-ve: have to attend every 3 months
Extras: can take 3 months for fertility to return

Question 5

Copper coil

Answer 5

CI: copper allergy, gynae Ca, PID last 3 months
How it works: spermicide
Treatment course: 5 yrs
S.E.: weight gain, heavy periods
+ve/-ve: can forget about it
Extras: > 40 y/o can have in until menopause

Question 6

Condoms

Answer 6

Only contraception to protect against STIs
Not as effective as other methods
Not good if latex allergy
Can be damaged by oil

Question 7

Vasectomy / ligation

Answer 7

Irreversible
Long term method
Risk of failure / surgical complications / bleeding / anaesthetic risk
Can take 3 months for sperm to be used up - f/u appts to check sperm count

Question 8

COCP

Answer 8

CI: migraine with aura, obesity, >35, smoker, stroke, DVT, PE, warfarin, breast Ca
How it works: prevents ovulation and implantation of egg
Treatment course: 23 days on, 7 days off
S.E: hormonal, weight gain, blood clots
+ve/-ve: take tablet daily, dec risk of ovarian Ca, inc risk of breast Ca
Extras: start on day 1 of cycle