Contraception

Question 1

what are the different options of the combined hormonal contraception?

Answer 1

the pill
the coil
the patch

Question 2

what are the non-contraceptive benefits from the combined hormonal contraception?

Answer 2

helps acne
help hirutism
stops ovulation therefore reduce/stop premenstrual syndrome
50% decrease in ovarian and endometrial cancer
decrease in functional ovarian cysts
decrease in benign breast tissue, rheumatoid arthritis, colon cancer

Question 3

what are the side effects from the combined hormonal contraception?

Answer 3

nausea
headache
breast tenderness
irregular bleeding in first 3 months

Question 4

how does the combined hormonal contraception work?

Answer 4

1 progestogen pill (synthetic progestogen)
1 oestrogen pill (ethinyl estradiol)
causes an increase in oestrogen and progesterone which triggers positive feedback to stop hypothalamus from releasing GnRH and therefore FSH and LH

Question 5

what are the 2 main types of intrauterine devices for contraception?

Answer 5

copper intrauterine device

levonorgestrel intrauterine device (progestogen)

Question 6

what are the side effects of progestogen only pill?

Answer 6

increase in appetite
hair loss/gain
mood change
acne
bloating 
headache

Question 7

what are the contraindications for progestogen only pill?

Answer 7

it is oestrogen free therefore little contraindications

• liver tumour
• previous personal history of breast cancer

Question 8

when should you start contraception?

Answer 8

if started first 5 days of the cycle then it will work immedietly
if started on other days of cycle then have to use other protection as well i.e. condoms

Question 9

after delivery when can you get pregnant again?

Answer 9

within 21 days

Question 10

can you get pregnant while breast feeding?

Answer 10

lactation acts as contraceptive for the first 6 months and if feeding for 4 hours and amenorrhoeic

Question 11

name 3 emergency contraceptives and when they should be taken.

Answer 11

levonorgestrel pill - within 72 hours (3 days)
ullipristal pill - within 120 hours (5 days)
copper IUD - within 120 hours (5 days)

Question 12

what are the side effects from progestogen injection?

Answer 12

delay in return to fertility (9 months)
bone density
weight gain

Question 13

what type of contraceptive is the rod?

Answer 13

progestogen only implant

Question 14

when can sex cause pregnancy?

Answer 14

you ovulate 2 weeks before period
egg survives 24 hours
sperm survives less than 4 days
usually highest chance of pregnancy is days 8-19

Question 15

what is a salpingectomy?

Answer 15

removal of fallopian tubes

Question 16

what is the name of the surgery which removes the fallopian tubes?

Answer 16

salpingectomy

Question 17

what effect does female sterillization have on periods?

Answer 17

no effect on periods/bleeding

Question 18

what is the risk of testicular and prostate cancer with a vasectomy?

Answer 18

no risk

Question 19

what medications are given for a medical termination of pregnancy?

Answer 19

mifepristone (oral anti progesterone tablet)

misoprolol (initiates uterine contractions)

Question 20

how is male vasectomy carried out?

Answer 20

vas deferens are separated and small ends are cauterised

irreversible as auto-sperm antibodies form so even if vas deferent were reconnected sperm wouldn’t be produced

Question 21

if someone has had unprotected sex, what sit testing can be offered and when?

Answer 21

vaginal swab:
- chlamydia and gonorrhoea 10 days after

blood test:
- HIV and syphyllis 2 months after

if high risk of BBV:
- hep B and C 2 and 6 months after

Question 22

give examples of non-hormonal contraception methods.

Answer 22

male condoms
female condom
diaphragm/cap
copper intrauterine device

Question 23

what are the different methods of progestogen only contraception?

Answer 23

pill
injection
implant
IUS - Mirena

Question 24

what are the 2 types of abortion in the UK?

Answer 24

medical - mifepristone and misoprostol

surgical

Question 25

when would you perform a surgical and medical abortion?

Answer 25

medical - up to 20 weeks

surgical 20-24 weeks

Question 26

what guidelines have to be assessed when prescribing contraception to an under 16 year old?

Answer 26

fraser guidlines - NSPCC website

child protection risk

Question 27

when can surgical termination be carried out?

Answer 27

locally - up to 12 weeks

refer to other - 12-24 weeks

Question 28

when can medical termination be carried out?

Answer 28

up to 20 weeks locally

Question 29

if a patient requests emergency contraception but she has already had in this cycle, what are her options?

Answer 29

if LNG - don’t use ullipristal within next 7 days

if Ullipristal - don’t use LNG within next 5 days