Contraception + HRT

Question 1

Menopausal woman - how long should contraception be continued from the last period - if > 50 years old

Answer 1

12 months after the last period

Question 2

Menopausal woman - how long should contraception be continued from the last period - if < 50 years old

Answer 2

24 months after the last period

Question 3

Traditional POP (Micronor, Noriday) - forgot to take pill, <3hr late

Answer 3

Take pill now, no further action

Question 4

Traditional POP (Micronor, Noriday) - forgot to take pill, >3hr late

Answer 4

Take (one) missed pill now
Take next pill at usual time
Extra protection for 48hr

Question 5

Progesterone injectable contraceptive - what factor is a UKMEC 4 contraindication?

Answer 5

Current breast cancer

Question 6

Progesterone injectable contraceptive - what factor is a UKMEC 3 contraindication?

Answer 6

Past breast cancer

Question 7

Levornogestrel emergency contraception dose

Answer 7

1.5mg
(3mg if >70kg or BMI >26)

Question 8

Progestogen implantable contraceptive (Nexplanon) - UKMEC3 contraindication to starting

Answer 8

IHD/stroke
Unexplained PV bleeding
Past breast cancer
Liver cancer
Severe liver cirrhosis

Question 9

Progestogen implantable contraceptive (Nexplanon) - UKMEC4 contraindication

Answer 9

Current breast cancer

Question 10

COCP reduces risk of which cancers

Answer 10

Bowel
Endometrial
Ovarian

Question 11

COCP increases risk of which cancers

Answer 11

Breast
Cervical

Question 12

COCP
>35y + smokes >15/day

Answer 12

UKMEC 4

Question 13

COCP
>35y + smokes <15/day

Answer 13

UKMEC 3

Question 14

COCP
BMI >35

Answer 14

UKMEC 3

Question 15

COCP
Controlled hypertension

Answer 15

UKMEC 3

Question 16

COCP
Thromboembolic disease in 1st degree relative <45y

Answer 16

UKMEC 3

Question 17

EllaOne (ulipristal acetate) dose

Answer 17

30mg

Question 18

EllaOne (ulipristal acetate) mechanism of action

Answer 18

Inhibition of ovulation

Question 19

EllaOne (ulipristal acetate) can be used up to

Answer 19

120 hours after UPSI

Question 20

Oestrogen-containing contraceptives and major surgery

Answer 20

Stop 4 weeks before
Restart once mobilising

Question 21

Levornogestrel emergency contraception must be taken within

Answer 21

Within 72 hours of UPSI

Question 22

Current breast cancer is UKMEC 4 contraindication for

Answer 22

All hormonal contraceptives

Question 23

Medications which may reduced efficacy of implantable contraceptive (Nexplanonon = etonorgestrel)

Answer 23

Enzyme inducers (rifampicin, carbemazepine)

Question 24

Extra precautions - If Levornogestrel-IUS (Mirena) is inserted on day 1-7 of cycle

Answer 24

No additional contraception required

Question 25

Extra precautions - If Levornogestrel-IUS (Mirena) is inserted outside day 1-7 of cycle

Answer 25

7 days additional contraception

Question 26

Quickstarting contraception after EllaOne (ulipristal acetate)

Answer 26

Start 5 days after EllaOne

Question 27

Emergency contraception option contraindicated in patient with severe asthma

Answer 27

Ulipristal acete (EllaOne)

Question 28

Breastfeeding and levornogestrel EC

Answer 28

No restrictions

Question 29

Breastfeeding and ulipristal EC

Answer 29

Breastfeeding should be delayed for 1 week after taking

Question 30

Copper IUD may be used as EC up to

Answer 30

5 days after UPSI or 5 days after likely ovulation date

Question 31

COCP and missed 2 pills Missed in week 1 (days 1-7)

Answer 31

Use condoms for 7 days Consider EC

Question 32

COCP and missed 2 pills Missed in week 2 (days 8-14)

Answer 32

Use condoms for 7 days No need for EC

Question 33

COCP and missed 2 pills Missed in week 3 (days 15-21)

Answer 33

Use condoms for 7 days Omit pill-free interval

Question 34

Cerazette POP (desogestrel) Forgot to take pill <12hr late

Answer 34

Take pill now No action needed

Question 35

Cerazette POP (desogestrel) Forgot to take pill >12hr late

Answer 35

Take missed pill now Take next pill at usual time Condoms for 48hr

Question 36

Mirena IUS as contraception - licensed for

Answer 36

5 years

Question 37

Mirena IUS as endometrial protection in HRT - licensed for

Answer 37

4 years

Question 38

Kyleena contains

Answer 38

19.5 mg levonorgestrel

Question 39

Mirena contains

Answer 39

52 mg levonorgestrel

Question 40

Jaydess contains

Answer 40

13.5 mg levonorgestrel

Question 41

Jaydess IUS - licensed for

Answer 41

3 years

Question 42

Premature menopause =

Answer 42

Definitve loss of ovarian function <40y

Question 43

Premature ovarian insufficiency =

Answer 43

Transient/permanent loss of ovarian function <40y

Question 44

Early menopause =

Answer 44

Cessation of ovarian function 40-45y

Question 45

QS CHC (COCP/patch/ring) day 1-5 of cycle

Answer 45

No precautions required

Question 46

QS CHC (COCP/patch/ring) on day 6 or later

Answer 46

Precautions for 7 days

Question 47

QS POP day 1-5 of cycel

Answer 47

No precautions required

Question 48

QS on day 6 onward

Answer 48

Precautions for 2 days

Question 49

QS progestogen depot day 1-5 of cycle

Answer 49

No precautions required

Question 50

QS progestogen depot day 6 onward

Answer 50

Precautions for 7 days

Question 51

QS progestogen implant day 1-5 of cycle

Answer 51

No precautions required

Question 52

QS progestogen implant day 6 onward

Answer 52

Precautions for 7 days

Question 53

QS levornogestrel IUS day 1-7 of cycle

Answer 53

No precautions required

Question 54

QS levornogestrel IUS day 8 onwards

Answer 54

Precautions for 7 days

Question 55

QS copper IUD

Answer 55

No requirements at any point of cycle

Question 56

LNG-EC - how long until you can quick-start HC?

Answer 56

Can QS immediately (will not effect LNG effectiveness)

Question 57

UPA-EC - how long until you can quick-start HC?

Answer 57

5 days (120hrs)