Contraception

Question 1

When can contraception be stopped after the menopause?

Answer 1

24 months after last period in a woman <50 yrs

12 months after last period in a woman >50yrs

Question 2

How does contraception also treat acne?

Answer 2

increases sex binding immunoglobulin that reduces testosterone in the blood

Question 3

What is special about the coil?

Answer 3

only type that isnt reduced in effacicy by liver enzymes

Question 4

How does the mirena coil work?

Answer 4

progesterone only
thickens the cervical mucus making a hostile environment
prevents endometrial proliferation

Question 5

How long does the mirena last for?

Answer 5

5 years

Question 6

What are the side effects of the mirena coil?

Answer 6

acne and headaches
can get cramps after insertion
bleeding is common for the first 6 months

Question 7

How does the copper IUD work?

Answer 7

direct toxic effect on sperm - decreases motility and survival
NON HORMONAL

Question 8

How long does the copper IUD last for?

Answer 8

5 or 10 years - depending on the type

Question 9

What are the side effects of the copper IUD?

Answer 9

heavy bleeding

Question 10

What type of coil can be used for emergency contraception?

Answer 10

copper

Question 11

What are the risk factors for coils?

Answer 11

difficult to fit in women with fibroid uterus’
increase risk of ectopic pregnancy
1 in 20 fall out

Question 12

What is the action of the rod?

Answer 12

progesterone hormone

thickens the cervical mucus and inhibits ovulation

Question 13

How long and effective is the rod?

Answer 13

lasts 3 years

most effective type of contraception

Question 14

Where is the rod inserted?

Answer 14

triceps subdermally

Question 15

What is the side effect of the rod?

Answer 15

bleeding

Question 16

How does combined contraception work?

Answer 16

oestrogen and progesterone

supresses ovulation

Question 17

What are examples of combined contraception?

Answer 17

vaginal ring
patch
combined pill

Question 18

Who is the combined contraceptive pill contraindicated?

Answer 18

high BMI
age >35yrs
smokers
FH of blood clots
migraine with aura
BP >140/90

Question 19

How do you take the CCP?

Answer 19

start within 5 days of your cycle

take for 21 days then a 7 day break

Question 20

What are the risks of CCP?

Answer 20

venous thrombosis
breast cancer risk increases
cervical cancer risk increases

Question 21

What are the benefits of CCP?

Answer 21

20% reduction in ovarian and endometrial cancer for every 5 yrs use

Question 22

How should CCPs be managed around surgery?

Answer 22

stopped 4 weeks before surgery

restarted 2 weeks later

Question 23

When can CCPs be restarted post partum?

Answer 23

6 weeks

Question 24

How does the progesterone only pill work?

Answer 24

progesterone

ovulation suppression and endometrial thinning

Question 25

How does the depo injection work?

Answer 25

progesterone
get it every 3 months - can be self administered
inhibited ovulation and thickens cervical mucus

Question 26

What are the benefits of the depo injection?

Answer 26

high chance of amenorrhea

good for those with learning difficulties/disabilities

Question 27

What are the downsides to the depo injection?

Answer 27

lowers oestrogen and FSH so risk of osteopenia - do DEXA scan
leads to weight gain

Question 28

How does the mechanical barrier of a diaphragm work?

Answer 28

cap goes round the cervix, cover in spermacide and put it in 3 hours before sex and keep it in for 6 hours after sex

Question 29

What are the tubual occlusion options for contraception?

Answer 29

vasectomy and female sterilisation (increases risk of ectopic pregnancy)