Contraceptives

Question 1

Name the different types of method by which contraceptives can impair fertility.

Answer 1

Preventing ovulation
Impairing Gametogenesis
Preventing gamete maturation
Interfering gestation

Question 2

Describe the types of OCP:

Answer 2

Oestrogen plus Progestin
Monophasic - same dose of hormones for 21 days then 7 days off.
Triphasic - increasing amounts of progesterone over the 2 weeks.

Question 3

What is the oestrogen in the OCP called?

Answer 3

Ethinyl Oestradial

Question 4

What is the progestin in the OCP called?

Answer 4

Norethindrone
Norethindrone acetate
Norgestrel
Levogestrel

Question 5

What is contained within the transdermal patch?

Answer 5

Ethinyl Oestradial

Norelgestromin

Question 6

How is the transdermal patch used?

Answer 6

One applied each week for 3 weeks to either abdomen, upper torso, buttock. Week 4 is patch three.

Question 7

How effective is the transdermal patch?

Answer 7

Does not work in women over 90kg
Efficacy is equal to OCP
Exposure to oestrogen is 60% than OCP however this may increase risk of side effects.

Question 8

What are the components of the vaginal ring?

Answer 8

Ethinyl Oestradial and etonogestrel

Question 9

How is the vaginal ring used?

Answer 9

Ring inserted into the vagina and left for three weeks. One week ring free..

Question 10

What is the progestin in the progestin only pill?

Answer 10

Norethindrone

Question 11

How is the progestin only pill taken?

Answer 11

Continuously

Question 12

How does the efficacy of the progestin only pill compared to OCP?

Answer 12

Less efficacious than OCP

More likely to produce irregular menstrual cycles.

Question 13

Indications for progestin-only pill?

Answer 13

Not usually accepted due to increase anxiety over pregnancy. However can be used in patients who are breast feeding, those intolerant to oestrogen, smokers or those with contra-indications to oestrogen.

Question 14

What is the agent in injectable progesterone?

Answer 14

Medroxyprogesterone acetate

Question 15

What are some of the adverse effects of depot progesterone?

Answer 15

Weight gain
Amennorhea
Delay return to fertility
Bone loss - max 2 years use

Question 16

How long can a subdermal implant provide contraception for?

Answer 16

3 years

Question 17

What does the implant contain?

Answer 17

Etonogestrel

Question 18

How effective is the implant?

Answer 18

Nearly as good as sterilisation.
doesn’t rely on patient compliance.
Totally Reversible
However not testes in those greater than 130% body weight so effectiveness is not known.

Question 19

What agent is contained within the intrauterine device?

Answer 19

Levonorgestrel

Question 20

How long can the intra-uterine device provide contraception for?

Answer 20

5 years

Question 21

When is the intrauterine device contraindicated?

Answer 21

Those with PID

Previous ectopic pregnancy

Question 22

Describe the options for post-coital contraception?

Answer 22

High doses of progesterone or high doses of oestrogen administered up to 72 hours after unprotected intercourse. 2nd dose then given 12 hours after first. Or progestin only - 1.5mg levonorgestrel.

Question 23

What are some contraindications to contraceptives?

Answer 23

CVS 
Thromboembolic disease
Oestrogen dependent neoplasms
Liver disease
pregnancy 
Combination can't be used in those over 35 and in heavy smokers.