Contraception

Question 1

Which types of cancers do combined contraceptives decrease the risk of?

Answer 1

1. Endometrial cancer
2. Ovarian cancer
3. Colon cancer

Question 2

Which type of cancers do combined contraceptives increase the risk of?

Answer 2

1. Cervical cancer
2. Breast cancer

History of these is a contraindication to having a Mirena

Question 3

Which type of contraception can be used while breastfeeding (combined vs progestogen)

Answer 3

Progesterone-only contraceptives

pill, depot, implants, Mirena

Question 4

Between combined and progestogen contraceptives, which is more easily reversible

Answer 4

Combined

Question 5

How often should a copper vs Mirena coil be changed?

Answer 5

Copper (IUD): Change every 5-10 days

Mirena (IUS): Change every 5 years

Question 6

How does the combined pill work

to prevent pregnancy

Answer 6

1. Suppress FSH and LH -> prevent ovulation
2. Thicken cervical mucus -> inhibits sperm transport
3. Thins endometrium -> prevents implantation of fertilised egg

Question 7

Between the combined and progesterone-only pill, which increases risk of VTE

Answer 7

Combined pill

Question 8

Types of combined hormonal contraception (3 types)

Answer 8

1. Combined pill
2. Nuvaring
3. Patches

Question 9

Types of progesterone only contraception (4 types)

Answer 9

1. Small pill
2. Depot injection (every 12 weeks)
3. Rod implant (every 3 years)
4. Mirena (every 5 years)

Question 10

Types of non-hormonal contraception (6 types)

Answer 10

1. Family planning
2. Condoms (M and F)
3. Diaphragm and caps
4. Spermicides
5. Sterilisation (M and F)
6. Copper coil

Question 11

How does the copper coil/ IUD

to prevent pregnancy

Answer 11

Slow release of copper ->
thickens cervical mucus ->
difficult for sperm to reach egg, prevents implantation

Question 12

How does the Mirena coil/ IUS

to prevent pregnancy

Answer 12

Slow release of progestogen ->
thickens mucus, alters utero-tubal fluid, suppresses endometrium ->
difficult for sperm to reach egg, prevents implantation

Question 13

3 types of emergency contraception

Answer 13

1. Levonelle (progesterone-only)
2. Ullipristal acetate
3. Copper coil/ IUD

Question 14

Most effective type of emergency contraception

Answer 14

Copper coil/ IUD

Question 15

How does Levonelle (progesterone-only morning after pill) work

Answer 15

Affects sperm function and endometrial receptiveness

If early in cycle, can prevent/ delay ovulation

Question 16

How does Ullipristal acetate work. What is it used for

Answer 16

Selective progesterone receptor antagonist

Prevents/delays ovulation
May prevent implantation

Question 17

How does copper coil/ IUD work as emergency contraception

Answer 17

Prevents implantations

Question 18

When should Levonelle (progesterone-only morning after pill) be taken by

Answer 18

Best within 24h

No later than 72h

Question 19

Important absolute contraindications to combined pill

Answer 19

• Migraine with aura
• Htn >160s or >95d
• VTE or thrombogenic mutation
• Stroke or IHD
• Breast feeding <6 weeks postpartum