Contraception

Question 1

What are the 3 methods of emergency contraception?

Answer 1

Levonorgestrel (Levonelle), Ulipristal (EllaOne),

Copper IUD

Question 2

What is the time-frame for giving Levonorgestrel as emergency contraception?

Answer 2

72 hours (3 days)

Question 3

What does taking the combined OCP do to your risk of breast, cervical, ovarian and endometrial cancers?

Answer 3

Breast - increased
Cervical - increased
Endometrial - protective
ovarian - protective

Question 4

Can the combined OCP cause an increase in migraine with aura?

Answer 4

yes

Question 5

A 24 year old female present to her GP with left sided headaches which are preceded by vision changes. She started the COCP 3 months previously. Examination is normal. What is the most appropriate management and why?

Answer 5

Change COCP to POP - patient has migraine with aura and COCP is contraindicated in these patients due to increased risk of ischaemic stroke

Question 6

If the pill is started on day 3 of the cycle, is extra contraception required for the first 7 days?

Answer 6

No - if the pill is started within the first 5 days no additional contraception is required. At any other time in the cycle, additional contraception is required for 7 days

Question 7

What are the UKMEC (UK medical eligibility criteria)?

Answer 7

Suitability of contraception methods in different medical conditions.
UKMEC 1: No restrictions for use
UKMEC 2: Benefits outweigh the risks
UKMEC 3: Risks generally outweigh the benefits (expert clinical judgement required if considering use due to other methods being unavailable)
UKMEC 4: Unacceptable risk

Question 8

What is the Pearl Index?

Answer 8

Quantifies failure rates of contraception
Measured in 100 women years in months (100x12)
Pearl index = no. of accidental pregnancies x 1200 x number of months of exposure

Question 9

What is the main mode of action of the Depo Provera?

Answer 9

Inhibits ovulation