Contraception

Question 1

Name 2 cancers that COCP increases risk of

Answer 1

Breast cancer (because of oestrogen exposure)
Cervical cancer

Question 2

Name 3 cancers that COCP reduces risk of

Answer 2

Endometrial cancer
Cervical cancer
Colorectal cancer

Question 3

Name 3 advantages of COCP

Answer 3

Makes periods regular, lighter and less painful
Easy to reverse
Reduces risk of cancers: ovarian, endometrial and bowel
May help with acne

Question 4

Name 2 disadvantages of COCP

Answer 4

Increased risk of pulmonary embolism/myocardial infarction
Increased risk of cancer: cervical, breast
Does not protect against STIs

Question 5

Name 2 advantages of progestogen-only pill

Answer 5

Easy to reverse

Can be used if combined pill is contraindicated

Question 6

Contraindications for combined pill?

Answer 6

BMI > 35
Breast feeding
Smoking over the age of 35 (avoid if smoke >=15/day)
Hypertension 
History or family history of VTE
Prolonged immobility or disability
Migraine with aura
Diabetes Mellitus with complications
Breast cancer or primary liver tumours

Question 7

Name 3 disadvantages of progestogen-only pill

Answer 7

Amenorrhoea
Side effects of acne, breast tenderness,weight gain
Ovarian cysts may develop
Small increased risk of breast cancer i.e norethisterone
Increased risk of ectopic pregnancy

Question 8

Name 2 advantages for progestogen injection

Answer 8

Works for 3 months

Can be used during breast feeding

Question 9

Name 3 disadvantages for progestogen injection

Answer 9

Not easily reversible - fertility may only return up to 1 year after stopping
Amenorrhoea
Weight gain

Question 10

Name 2 advantages of progestogen-only subdermal implant

Answer 10

Can be used during breast feeding
Effects last for 3 years
Immediate return to fertility after implant removed

Question 11

Name 3 disadvantages of progestogen-only subdermal implant

Answer 11

Amenorrhoea
Irregular bleeding
Requires small procedure to fit

Question 12

Name 3 disadvantages of copper coil (IUD)

Answer 12

Increased risk of ectopic
Increased risk of uterine perforation
Increased risk of PID (within first 20 days of insertion)
Increased risk of spotting (intermenstrual bleeding)

Question 13

Name 3 advantages of IUS

Answer 13

Reduced blood loss during period
Reduced painful periods
Reduced risk of ectopic
No increased risk of cancer
Lasts 5 years---> Ease of use --> no need to think about it

Question 14

Name 3 disadvantages of IUS

Answer 14

Irregular periods or amenorrhoea
Increased risk of PID 
Risk of expulsion
Risk of uterine puncture
Can get headaches, acne, breast tenderness once inserted.

Question 15

What are the Fraser criteria?

Answer 15

1. The young person understands the practitioner’s advice.
2. The young person cannot be persuaded to inform their parents, or will not allow the practitioner to inform the parents, that contraceptive advice has been sought.
3. The young person is likely to begin or to continue having intercourse with or without contraceptive treatment.
4. Unless he or she receives contraceptive advice or treatment, the young person’s physical or mental health (or both) are likely to suffer.
5. The young person’s best interest requires the practitioner to give contraceptive advice or treatment (or both) without parental consent.