Contraception

Question 1

What 7 things is it important to ask about in a medical history before prescribing contraceptives?

Answer 1

1) Diabetes
2) Migraine with aura
3) Cardiac disease
4) lupus (as it increases risk of thromboembolism as does pill)
5) Obesity
6) Smoking
7) Medication they’re currently on
8) Family history (VTE, osteoporosis, breast cancer), sexual history, gynae history

Question 2

How long can sperm survive for?

Answer 2

Max. of 7 days (average 1.47 days)

Question 3

How long can eggs survive for?

Answer 3

24hrs

Question 4

What day is conception most likely to occur following UPSI?

Answer 4

On the day of ovulation or in the preceeding 24hrs

Question 5

Name 2 natural methods of contraception

Answer 5

1) Fertility awareness method

2) Lactational Amenorrhoea Method

Question 6

Name a few advantages of FAM

Answer 6

1) No hormones
2) no alteration to menstrual cycle
3) help with conception in future as aware of cycle

Question 7

Name a few disadvantages of FAM

Answer 7

1) Less effective than other methods
2) no intercourse for 8-9 days + per cycle
3) user dependent
4) no protection from STIs

Question 8

How does the combined pill work?

Answer 8

Inhibition of ovulation via action on hypothalamo-pituitary-ovarian axis to reduce LH and FSH

Question 9

Name a few advantages of combined hormonal contraception (CHC)

Answer 9

1) Regulates menstruation
2) decreases blood flow and period pains
3) decreases risk of endometrial and ovarian cancer
4) decreases risk of colorectal cancer
5) improves acne

Question 10

Name a few disadvantages of CHC

Answer 10

1) Doubles risk of VTE
2) increased risk of stroke
3) small increased risk of breast cancer
4) relies on user taking it corrrectly
5) increased risk of cervical cancer

Question 11

Which patients would you not prescribe progesterone only contraception for?

Answer 11

1) cardiovascular disease (only with depo)
2) unexplained vaginal bleeding (e.g. post-coital bleeding)
3) Breast cancer
4) Liver disease