Contraception

Question 1

How effective of the combined pill?

Answer 1

Over 99%

Question 2

What are the 2 hormones in the combined pill?

Answer 2

Ethinyl oestradiol

Synthetic progesterone

Question 3

What is the normal dose of the combined pill?

Answer 3

20-35 micrograms

Question 4

What is the mode of action of the combined pill?

Answer 4

Prevents ovulation by altering FSH and LH to prevent surge
Prevents implantation as provides inadequate endometrium
Inhibits sperm penetration of cervical mucus by changing quality and character

Question 5

How do you take the combined pill?

Answer 5

Start at any time if not pregnant
Use barrier contraception for 7 days
Can use up to 3 months continuously

Question 6

What are the non contraceptive benefits of the combined pill?

Answer 6

Regular bleed with potential reduction in painful heavy periods and anaemia
Reduction in functional ovarian cysts
50% reduction in ovarian and endometrial cancer
Improvement in acne
Reduction in benign treat disease, rheumatoid arthritis, colon cancer and osteoporosis

Question 7

What are the risks of the combined pill?

Answer 7

Increased risk of venous thromboembolism and cervical cancer

Question 8

What is the effect of the combined pill on the risk of venous thromboembolism?

Answer 8

Triples

Question 9

What is the effect of the combined pill on the risk of cervical canecr>

Answer 9

Doubles with 10 years use

Question 10

WHow effective id the progesterone only pill?

Answer 10

99% but user dependent

Question 11

What is the mode of action and dose of the progesterone only pill>

Answer 11

Cervical mucus becomes impenetrable

75 micrograms

Question 12

When is the progesterone only pill at its most effective?

Answer 12

48 hours after use

Question 13

What is the window for taking the progesterone only pill?

Answer 13

Within 3 hours of same time every day

Question 14

What is the “injection”?

Answer 14

Depot medrocyprogesterone acetate injection

Question 15

How effective if the depot injection?

Answer 15

Over 99%

Question 16

What is the mode of action of the depot injection?

Answer 16

Prevents ovulation
Alters cervical mucus
Prevents implantation by rendering endometrium unsuitable;le

Question 17

What are the benefits of the depot injection?

Answer 17

Oestrogen free

Good for forgetful pill takers

Question 18

What are the risks of the depot injection?

Answer 18

Delay in resturn o fertility
Reversibe reduction in bone density
Problematic bleeding
Weight gain

Question 19

What is the subdermal implant comprised of?

Answer 19

68mg of progesterone etongestrel in EVA matrix cover in rate controlling membrane

Question 20

What is the mode of action of the implant?

Answer 20

Primary- inhibit ovulation

Secondary- effect on cervical mucus

Question 21

What are the 2 types of IUD?

Answer 21

Copper

Mirena

Question 22

What is the mode of action of the copper coil?

Answer 22

Irritates endometrium
Spermicide
Alters cervical mucus

Question 23

What is the mode of action of the Mirena coil?

Answer 23

Alters cervical mucus

Can prevent ovulation

Question 24

What are the methods of barrier contraception?

Answer 24

Condom
Female condom
Diaphragm
Cervical cap

Question 25

What is the lifetime failure rate of female sterilisation?

Answer 25

1 in 500

Question 26

What is the lifetime failure rate of vasectomy?

Answer 26

1 in 2000

Question 27

Why is pain common after a vasectomy?

Answer 27

Sperm granuloma, a mass of degenerating spermatozoa surrounded by macrophages

Question 28

What are the options for emergency contraception?

Answer 28

Copper IUD- most effective Levonogestrel aka Levonelle ellaOne

Question 29

When can Levonelle be used?

Answer 29

1.5mg within 72 hours

Question 30

When can ellaOne be used?

Answer 30

30mg within 120 hours

Question 31

When can the copper coil be used as emergency contraception?

Answer 31

Within 5 days, or up to 5 days after the earliest time one could have ovulated

Question 32

What are the 2 types of abortion?

Answer 32

Medical | Surgical

Question 33

What % of abortions are medical?

Answer 33

>80%

Question 34

What is the method of action of a medical abortion?

Answer 34

Mifepristone switches off pregnancy hormone and causes uterus to contract 48 hours later, prostaglandin initiated uterine contraction to open cervix and expel pregnancy

Question 35

What are the indications for abortion?

Answer 35

The pregnancy has not exceeded 24 weeks and continuation of the pregnancy would cause greater harm to the physical or mental health of the woman and/or her existing children than if the pregnancy were terminated Medical- foetal abnormality or maternal health

Question 36

What should be discussed in a consultation pre abortion?

Answer 36

Consult on methods Offer counselling for after termination FBC and self obtained swab for chlamydia and gonorrhoea, and STI bloods offered Advise on prolonged bleeding

Question 37

What are the possible complications of abortion?

Answer 37

``` Failure Haemorrhage Infection Prolonged bleeding Uterine perforation Cervical trauma Retained products of conception Decreased fertility ```

Question 38

What is the likelihood of failure of termination?

Answer 38

<5 in 100

Question 39

What is the likelihood of haemorrhage or prolonged bleeding after termination?

Answer 39

<5 in 100