Contraception

Question 1

How does the COCP work?

Answer 1

Inhibits ovulation

Question 2

How does the POP work?

Answer 2

Thickens cervical mucus

Question 3

How does depo-provera work?

Answer 3

Inhibits ovulation

thickens cervical mucus to a lesser extent

Question 4

How does the implant work?

Answer 4

Inhibits ovulation

thickens cervical mucus to a lesser extent

Question 5

How does the coil work?

Answer 5

Decreases sperm motility and survival

When used as emergency contraception it is also toxic to sperm and ovum/ prevents implantation

Question 6

How does the IUS work?

Answer 6

Increases uterine thickness (Endometrial)

Thickens mucus

Question 7

Remember that contraception is required for 21 days post-partly

Answer 7

The following can be started at any time:

• POP
• Implant
• Injection
• IUD and IUS if inserted within 48 hours
• COCP can be started 4 weeks after if not breastfeeding, 6 weeks if

Question 8

COCP are absolutely contraindicated in some aged >35 who smokes >15 cigarettes per dat

Answer 8

COCP are absolutely contraindicated in some aged >35 who smokes >15 cigarettes per dat

Question 9

If 1 pill is missed, take it as soon as remembered about. No need for emergency contraception.
What is the advice if 2 pills are missed?

Answer 9

• take the last missed pill e.g. ok to take 2 pills in 1 day
• pills missed in week 1 = consider emergency contraception if unprotected sex in pill-free or week 1
• pills missed week 2 = no need for emergency contraception (assuming 7 pills taken previous week)
• pills missed week 3 = finish pills in current pack and start new pack immediately - miss pill free interval

Question 10

If not taken on day 1 of period when do different types of contraception take effect?

Answer 10

• IUD = immediately
• POP = 2 days
• COCP, injection, implant and IUS

Question 11

Why is it unsafe to insert an IUD between 48 hours and 4 weeks post-partum?

Answer 11

Because of the risk of uterine perforation

Question 12

Breast cancer is a contraindication to which types of contraception?

Answer 12

The only option is the copper IUD

Best for past and current breast cancer

Question 13

The COCP should not be used int women with a BMI >35

Answer 13

The risk is grade 3

Question 14

How does blood pressure affect risk of of using pill?

Answer 14

BP >160/95 is and absolute CI

BP > 140/90 IS GRADE 3

Question 15

Which type of contraception is CI in ladies with cardiomyopathy which affects heart function?

Answer 15

COCP

Question 16

For women with long QT syndrome, insertion of an IUD or IUS is grade 3 due to…

Answer 16

The risk of bradyacardia as a result of the valsalva during insertion

Question 17

Gestational trophoblastic disease is a CI for which type of contraception?

Answer 17

IUD

IUS