Contraception

Question 1

Define method failure

Answer 1

pregnancy despite correct use by user

Question 2

Define user failure

Answer 2

pregnancy because method not used correctly by user

Question 3

When do women ovulate?

Answer 3

Likely to ovulate on day 12-18

Question 4

How long does an egg survive ?

Answer 4

24hours

Question 5

How long do sperm survive?

Answer 5

4 days

Question 6

What two hormones make up the combined pill?

Answer 6

Ethinyl estradiol and progestin

Question 7

What is the affect of the combined pill on cervical mucus and endometrium?

Answer 7

it stops ovulation and thickens cervical mucus

Question 8

How is the combined pill taken?

Answer 8

Taken daily for 21 days with 7 days hormone free

Question 9

When is the combined patch changed?

Answer 9

Weekly

Question 10

When is the combined ring changed?

Answer 10

every three weeks

Question 11

Besides contraception, why would the combined pill be taken?

Answer 11

Regulates bleeding, stops ovulation and helps PMS, Reduces functional ovarian cysts, improves acne/hirsutism,, reduction in ovarian and endometrial cancer, benign breast disease, Rheum.Arthritis, colon cancer and osteoporosis

Question 12

What are the side effects of the combined pill?

Answer 12

Breast tenderness, nausea, headache, irregular bleeding for first three months, affects mood, weight gain

Question 13

What are the risks involved in taking the combined pill?

Answer 13

Increased risk of venous and arterial thrombosis
Avoid if active gall bladder disease
Increased risk of cervical/breast cancer

Question 14

How is the progesterone only pill taken?

Answer 14

same time every day without a pill-free interval

Question 15

What type of progesterone only pill has a 12 hour window?

Answer 15

Desogestrel

Question 16

What type of mini pill has a 3 hour window?

Answer 16

LNG NET pill

Question 17

What are the side effects of the mini pill?

Answer 17

Appetite gain
Hair loss/gain
Bloating/fluid retention
Headache 
Mood change
Acne

Question 18

How is injectable progestogen administered ?

Answer 18

Injection by GP into buttock every 13 weeks

Question 19

How does the progestogen injection prevent pregnancy?

Answer 19

Prevents ovulation, makes cervical mucus hostile to sperm, makes endometrium unsuitable for implantation

Question 20

What side effects does the injection carry?

Answer 20

Delay of 9months in return to fertility

Reversible reduction in bone density

Problematic bleeding in first two doses

Question 21

How much weight can women gain whilst using injectable progestogen?

Answer 21

2-3kg

Question 22

How does the implant function?

Answer 22

Inhibits ovulation. Lasts 3 years

Question 23

What side effect is more common in the implant than in any other method of contraception?

Answer 23

mood changes

Question 24

How long does The Coil last for?

Answer 24

5-10 years

Low risk of expulsion, infection and perforatiom

Question 25

What form of contraception is The Coil?

Answer 25

LARC

Question 26

If a pregnancy occurs whilst using the coil, what could happen?

Answer 26

Ectopic pregnancy

Question 27

How does the Copper IUD work?

Answer 27

It acts as a spermacide | it is hormone free

Question 28

What is a side effect of the copper IUD?

Answer 28

Makes periods heavier/crampier

Question 29

How does Levonorgestrel IUS function?

Answer 29

Slow release of progesterone which still allows for ovulation but affects cervical mucus and endometrium

Question 30

What brand of IUS can treat heavy menstrual bleeding?

Answer 30

Mireena (lasts 5 years)

Question 31

What brand of IUS is bleeding still possible ?

Answer 31

Kyleena (5 years) and Jaydess (3 years) as they contain less hormones

Question 32

When in the cycle should a woman start contraception?

Answer 32

First 5days in cycle will result in immediate protection

Question 33

What is the most effective form of emergency contraception?

Answer 33

the copper IUD

Question 34

When can levonorgestrel be taken?

Answer 34

up to 27 hours after intercourse

Question 35

When ulipristal be taken?

Answer 35

up to 120 hours after intercourse

Question 36

If contraception is not taken within the first 5 days of the cycle, what should the patient do?

Answer 36

Use a secondary form of contraception for 7 days and a pregnancy test after 4 weeks

Question 37

After delivering a baby, how many days does it take before you can get pregnant again?

Answer 37

21 days after delivery

Question 38

After miscarriage/abortion, how many days does it take before you can get pregnant again?

Answer 38

5 days after

Question 39

When is breast feeding contraceptive?

Answer 39

Breast feeding is only contraceptive in first 6 months IF FEEDING EVERY 4 HOURS AND MOTHER IS AMENORRHOEIC

Question 40

Describe the procedure behind female sterilisation?

Answer 40

Laproscopic procedure with filshie clips attached across tube to block lumen Procedure is irreversible

Question 41

What does female sterilisation reduce the risk of?

Answer 41

Ovarian cancer, especially with salpingectomy

Question 42

How is a vasectomy performed?

Answer 42

Vas Deferens is divides and cauterised via a small incision in midline of scrotum

Question 43

How long is it until a vasectomy is successful?

Answer 43

4-5 months

Question 44

Why is a vasectomy irreversible ?

Answer 44

anti sperm antibodies will have formed, even if the tubes are reconnected

Question 45

How many women in the UK terminate pregnancy?

Answer 45

1in3 women

Question 46

What is the most common age group for termination of pregnancy?

Answer 46

ages 20-24

Question 47

How is a surgical abortion carried out?

Answer 47

- Cervical priming – misoprostol 3hours preop helps dilation and reduces risk perforation/haemorrhage - GA or LA cervical block - Transcerival – 6-10mm suction catheter

Question 48

How is a medical procedure carried out?

Answer 48

- Mifepristone oral tablet given - Misoprostol taken 36-48 hours later which initiates uterine contraction, opens cervix and expels pregnancy - Average 4-6 hours to expel pregnancy <12 weeks