Contraception

Question 1

Emergency contraception available

Answer 1

Levonorgestrel 1.5mg within 72 hours
IUD within 120 hours
Ulipristal acetate 30mg within 120 hours

Question 2

Contraindications for levonorgestrel emergency contraception

Answer 2

Allergy
Malabsorption syndromes
Liver inducing enzymes e.g rifampicin
Ovulation already occurred

Question 3

Contraindications for ulipristal acetate

Answer 3

Pregnancy
Breast feeding
Already been used during same menstrual cycle
Liver inducing enzymes

Question 4

What advice do you need to give about contraception after prescribing ulipristal acetate

Answer 4

Interacts with oral contraceptives so use barrier contraception for 2 weeks following

Question 5

What advice do you need to give about contraception after prescribing levonorgestrel

Answer 5

Start taking normal contraceptives again within 12 hours

Question 6

Contraindications for IUD

Answer 6

PID
Wilson's disease
Allergy 
Active STI 
Endometrial or cervical cancer 
Abnormal uterine cavity shape

Question 7

Advice if missed pill

Answer 7

Take missed pill as soon as possible and take next pill at normal time
Use barrier contraception for at least 48 hours if POP and 7 days if COCP
May need emergency contraception

Question 8

MoA of COCP, IUS, progestogen depot injection and implant

Answer 8

Inhibit ovulation
Thicken cervical mucus
Prevent implantation

Question 9

MoA of POP

Answer 9

Thicken cervical mucus

Question 10

Disadvantages of progesterone depot

Answer 10

Decreased bone density leading to pathological fractures
Decreased fertility for >1 year after stopping
Breast tenderness
Acne
Irritability
Weight gain

Question 11

Contraindications for COCP

Answer 11

Smokers >35
Migraine with aura
Weight >90kg
Previous or family history of VTE

Question 12

When can you start contraception post partum

Answer 12

21 days post partum

Unless COCP - restart when no longer breastfeeding