Contraception

Question 1

List the common methods of contraception

Answer 1

natural family planning 
barrier eg condom 
COCP
mini pill
Coils - mirena or copper
progesterone injection or implant
surgery

Question 2

Eligibility criteria

Answer 2

1 –>4

4 means it is contraindicated

Question 3

what does 99% effective mean?

Answer 3

average person used it correctly with regular partner for 1 year
1% chance of pregnancy

Question 4

What types are user dependent?

Answer 4

condoms, pill, family planning

Question 5

risk factors

Answer 5

breast cancer
cervical or endometrial cancer - avoid coil
wilsons disease - avoid copper coil

Question 6

risk factors COCP

Answer 6

uncontrolled hypertension 
migraine with aura 
history of VTE
smoking 
vascular disease 
SLE
history of breast cancer

Question 7

older women

Answer 7

after last period need contraception for 2 years
HRT does not prevent pregnancy
COCP until 50years
injection stopped before 50 - osteoporosis

Question 8

When should amenorrhoeic women taking mini pill stop?

Answer 8

FSH blood test above 30

55 years old

Question 9

under 20yrs

Answer 9

implant is a good choice for LARC
coils - risk of expulsion
injection - osteoporosis

Question 10

after childbirth

Answer 10

needed 22 days after birth
lactational amenorrhoea is 98% effective until 6 months
COCP avoided in breastfeeding
mini pill or implant safe with breastfeeding

Question 11

Most effective emergency contraception

Answer 11

IUD

Question 12

When can an emergency IUD be used?

Answer 12

up to five days after sex or up to five days after earliest time you could have ovulated

Question 13

emergency contraceptive pill (active ingredient)

Answer 13

ulipristal acetate
120 hours after sex
or levonorgestrel up to 72 hours after sex

Question 14

How does contraceptive injection work?

Answer 14

release progesterone to stop ovulation and thicken cervical mucus

Question 15

Name some contraceptive injections

Answer 15

Depo-Provera
sayana press
noristerat

Question 16

How long do contraceptive injections last?

Answer 16

depo and sayana press = 13 weeks

noristerat = 8 weeks

Question 17

disadvantages of injection

Answer 17

periods and infertility take time to return after stopping
weight gain
risk of low bine mineral density

Question 18

Implant

Answer 18

fitted in arm under LA - lasts 3 years
periods may be irregular, stop or last longer
should be able to feel under skin
release progesterone

Question 19

IUS

Answer 19

Mirena - lasts 3-5 years
can make periods, shorter and lighter and less painful
check for threads

Question 20

risks with IUS

Answer 20

irregular bleeding
infection up to 20 days after insertion
ovarian cysts

Question 21

What cancers does COCP reduce the risk of?

Answer 21

colon, ovary and uterus

Question 22

Who is COCP not suitable for?

Answer 22

overweight or smoker >35 years

Question 23

Temporary side effects of the COCP

Answer 23

nausea, mood changes, breast tenderness

Question 24

What can make the pill less effective?

Answer 24

antibiotics, diarrhoea and vomiting, missed pills

Question 25

when is the progesterone only pill not effective?

Answer 25

taken more then 3 hours late