contraception

Question 1

when is the highest chance of sex causing pregnancy ?

Answer 1

days 8-19

Question 2

what are options for the combined hormonal contraception ?

Answer 2

pill - o/d anytime, not good for GI upset
patch - change weekly
ring - change every 3 weeks

Question 3

what is in the combined hormonal contraception and what is the regime ?

Answer 3

ethinyl estradiol
synthetic progesterone

21 day regime with hormone free week

Question 4

what are non-contraceptive benefits to the combined methods ?

Answer 4

regulate/reduce bleeding
stop ovulation - reduce PMS
reduction in functional ovarian cysts
reduce ovarian and endometrial cancers
improve acne/hirsutism
reduce breast disease, RA, colon cancer, osteoporosis

Question 5

what are side effects of the combined methods ?

Answer 5

breast tenderness
nausea
headache
irregular bleeding first 3 month

weight gain, mood

Question 6

what are serious risks associated with combined method ?

Answer 6

increase venous thrombosis + arterial thrombosis
avoid if gall bladder disease/liver tumour
increase risk of cervical cancer/breast cancer

Question 7

what is the regime of the progesterone only pill ?

Answer 7

take same time every day
no pill free interval

not good for GI upset

Question 8

what are contraindications for the POP ?

Answer 8

breast cancer

liver tumour

Question 9

what are side effects of the POP ?

Answer 9

appetite increase
hair loss/gain
mood change
bloating, fluid retention
headache
acne

Question 10

what is the effect of the progesterone depo injection ?

Answer 10

prevents ovulation
alters cervical mucous making it hostile to sperm
makes endometrium unsuitable for implantation

Question 11

what are downsides of the progesterone injection ?

Answer 11

delay in return to fertility
reversible reduction in bone density
problematic bleeding in first 2 dose
weight gain

Question 12

what are pros of the progesterone implant ?

Answer 12

can last 3 years
no user input needed
no effect on weight

Question 13

what are cons of the progesterone implant ?

Answer 13

30% prolonged frequent bleeding

mood changes

Question 14

what are pros of the intrauterine contraception (the coil)?

Answer 14

little user input
can be fitted any age or parity
fitting takes 10 mins

Question 15

what are features of the copper IUD ?

Answer 15

hormone free
may make periods heavier/crampier
can last 5-10 years

Question 16

what are features of the levonorgestrel IUS ?

Answer 16

mirena

slow release progesterone
low circulating level
reduce menstrual bleeding

Question 17

what are options for emergency contraception ?

Answer 17

copper IUD - most effective, within 120 hours
levonorgestrel pill - within 72 hours
ulipristal pill - within 120 huurs

Question 18

when do you start contraception ?

Answer 18

first 5 days of cycle - immediate cover

Question 19

how long does is take vasectomy to become effective ?

Answer 19

4-5 months

Question 20

what happens during surgical termination of pregnancy ?

Answer 20

misoprostol to prime cervix
anaesthetic block
suction catheter

risk of infection

Question 21

what is medical termination of pregnancy ?

Answer 21

mifepristone oral anti progesterone tablet

36-48 hours later misoprostol expels pregnancy