Contraception & HRT

Question 1

What are the different types of contraception offered?

Answer 1

Barrier methods
Pills: COCP, POP
Injection
Implants
Patch
IUD/IUS

Question 2

What is Nexplanon?

Answer 2

Nexplanon is an implant that contains the progestin etonogestrel.

Question 3

What is EllaOne? What does it contain?

Answer 3

EllaOne is an emergency contraceptive pill.

It contains ullipristal acetate.

Question 4

How long does EllaOne works for?

Answer 4

EllaOne works for 5 days.

Question 5

Give an example of a contraceptive injection.

Answer 5

Depo-provera

Question 6

Who is contraindicated in using Depo-provera?

Answer 6

Depo-provera is contraindicated in those with blood clots, or previously have had blood clots.
It is also KI in those with liver disease, unexplained vaginal bleeding and breast cancer.

Question 7

Who is contraindicated in Combined Oral Contraceptive pill?

Answer 7

• Smokers above age 35
• Pre-existing CVD
• History of thromboembolism (DVT or PE)
• Familial tendency to form blood clots: Familial Factor V Leiden
• High BP

Question 8

What is offered to those with menorrhagia and wants contraception?

Answer 8

Mirena coil

Question 9

How long can Nexplanon be effective for?

Answer 9

3 years

Question 10

How long can Mirena coil and copper coil be effective for?

Answer 10

5 years

Question 11

Can condoms protect users against STI?

Answer 11

Yes

Question 12

Can diaphragm protect users against STI?

Answer 12

No

Question 13

What other substance must be used together with the diaphragm?

Answer 13

Spermicide

Question 14

What question should be asked before prescribing HRT to patients?

Answer 14

Ask if there is a family history of DVT or thromboembolism as HRT doubles the risk of venous thromboembolism.

Question 15

What are the 3 different broad categories of HRT available? Who are they suitable for?

Answer 15

1. Oestrogen only - suitable for patients with no uterus.
2. Sequential combined - for patients with a uterus and are having monthly bleeds.
3. Continuous combined - suitable for patients with a uterus, and have had NO periods for 2 years if <50yo, for 1 year if >50yo, or older than 54yo.

Question 16

What are the common side effects of HRT?

Answer 16

Breast tenderness
Nausea
Headache
Indigestion
Tummy ache
Vaginal bleeding

Question 17

What are the alternative medications that can be given instead of HRT?

Answer 17

Tibolone
Clonidine - helps reduce hot flushes and night sweats
anti-depressants - also helps reduce hot flushes and night sweats

Question 18

Who is Tibolone suitable for?

Answer 18

Tibolone is only suitable for women whose last menstrual period was more than a year ago.