Contraception

Question 1

Give two types of emergency contraception

Answer 1

Intrauterine Device (coil)
Emergency contraceptive pill (morning after pill)

Question 2

Give two examples of emergency contraceptive pills

Answer 2

Levonelle - synthetic version of progesterone

EllaOne - contains ulipristal acetate, a progesterone antagonist

Question 3

When must an IUD be inserted in order to provide effective emergency contraception?

Answer 3

Can be inserted up to 120 hours (5 days) after unprotected sex, or up to 5 days after earliest time of ovulation

Question 4

When must Levonelle be taken in order to provide effective emergency contraception?

Answer 4

Must be taken within 72 hours of unprotected sex / earliest time of ovulation

Question 5

When must EllaOne be taken in order to provide effective emergency contraception?

Answer 5

Must be taken within 120 hours (5 days) of unprotected sex / earliest time of ovulation

Question 6

What are the contraindications for inserting an IUD as emergency contraception?

Answer 6

Untreated STI / pelvic infection
Some uterus/cervix anatomical abnormalities
Unexplained vaginal bleeding
?heart conditions

Question 7

What are the contraindications to giving EllaOne as an emergency contraceptive?

Answer 7

Asthma that is treated with steroids
Allergy to drug
Taking other medications such as those for TB, HIV or epilepsy, or omeprazole

Question 8

What hormone(s) are administered by the hormonal coil (intrauterine system, IUS)?

Answer 8

Progesterone only

Question 9

What hormone(s) are administered by the contraceptive implant?

Answer 9

Progesterone only

Question 10

What hormones are including in combined hormonal contraceptive methods such as the combined oral contraceptive pill?

Answer 10

Ethinyl oestradiol (EE)
Progesterone (usually a synthetic version)

Question 11

What hormone(s) are administered by the contraceptive patch?

Answer 11

Combined: Ethinyl oestradiol (EE) and progesterone

Question 12

What hormone(s) are administered by the vaginal ring?

Answer 12

Combined: Ethinyl oestradiol (EE) and progesterone

Question 13

What non-hormonal contraceptive methods are available?

Answer 13

Copper coil - lasts for ten years
Barrier methods:
- condoms
- diaphragm/cap with spermicide

Question 14

How long does the hormonal coil last for?

Answer 14

5 years or 3 years, depending on type

Question 15

How often must progesterone injections be given?

Answer 15

every 12 - 13 weeks

Question 16

How long does the contraceptive implant last for?

Answer 16

3 years

Question 17

Describe the mechanism of action of combined hormonal contraceptive methods

Answer 17

Main mechanism: prevent ovulation

Also have some effect of thickening cervical mucous and thinning the endometrial lining

Question 18

Describe the mechanism of action of the progesterone injections

Answer 18

Prevent ovulation

Also thicken cervical mucus and thin endothelial lining

Question 19

Describe the mechanism of action of the progesterone-only pill

Answer 19

Main mechanism: thicken the cervical mucus

Sometimes prevent ovulation

Question 20

Describe the mechanism of action of the IUS (hormonal coil)

Answer 20

Main mechanism: thicken the cervical mucus

Sometimes prevent ovulation

Question 21

Give three mechanisms of hormonal contraceptive methods

Answer 21

Prevent ovulation
Thicken cervical mucus
Thin endothelial lining

Question 22

What procedure permanently sterilises males?

Answer 22

Vasectomy - vas deferens are cut, blocked or sealed

Question 23

What procedures permanently sterilise females?

Answer 23

Tubal occlusion - clips/rings used to block fallopian tubes
Fallopian implant (essure) - this has been discontinued in the UK!

Question 24

What are the potential complications of a vasectomy?

Answer 24

Sperm granuloma (very painful)

Question 25

What are the potential complications of tubal occlusion?

Answer 25

Internal bleeding

Infection

Question 26

What are the failure rates of sterilastion?

Answer 26

Male (vasectomy): 1 in 2000

Female (tubal occlusion): 1 in 200