Fertility Control

Question 1

COC tablets?

Answer 1

Monophasic 21 days - E and P same level

Multiphase 28 days- variable E and P in each tablet

Question 2

Transdermal patches are worn?

Answer 2

Each week for 3 weeks, with withdrawal bleed

Question 3

Vaginal rings are worn?

Answer 3

3 weeks then 1 week off

Question 4

Factors contributing to failure?

Answer 4

More than 90kg
Malabsorption
Drug interaction ( affecting gut flora so affects recycling of hormones)/ enzyme inducing drugs

Question 5

Benefits CHC?

Answer 5

Reduced risk of colorectal, ovarian, endometrial cancer
Predictable bleeding
Reduced dysmenorrhoea pains and menorrhagia heavy
Management of pcos symptoms
Reduce acne
Reduce menopausal symptoms
Maintaining bone density

Question 6

Risks with CHC?

Answer 6

Risk of cervical and breast cancer

Venous thromboembolism x3 more likely to have blood clot

Question 7

Risk of VTE with CHC?

Answer 7

5 and 12 per 10,000

Question 8

Lower risk of VTE taking COC?

Answer 8

Levongestrol, norethisterone and norgestimate

Question 9

Oral progesterone only work by?

Answer 9

Alter cervical mucus to prevent sperm perpetration, possibly inhibit ovulation

Question 10

Long acting progesterone in an injection for 8weeks?

Answer 10

Norethisterone enantate

Question 11

Mirena and jaydesss release?

Answer 11

Levonorgestrel into uterine cavity, over 5 years

Question 12

Levonegsterol action?

Answer 12

Thickening of cervical mucus and prevention of endometrial proliferation, suppress ovulation

Question 13

Levonorgestrel is effective after unprotective sex?

Answer 13

Within 72 hours

Question 14

Side effects of testosterone?

Answer 14

Acne, increased weight, mood changes, night sweats altered libido

Question 15

VTE events occurring with CHC are what percent fatal?

Answer 15

1%

Question 16

Greater risk of arterial clots if CHC contains?

Answer 16

Higher EE (ethinylestradiol)

Question 17

Desogestrol role?

Answer 17

Inhibits ovulation

Question 18

Injection of progesterone only?

Answer 18

Medroxyprogesterone acetate

Delay of return to fertility and irregular cycles for a while

Question 19

Long acting rod progesterone implant for 3 years?

Answer 19

Etonogestrel releasing

Bruising and itchy of site of injection

Question 20

Hormonal emergency contraceptive alternative option?

Answer 20

Copper intra uterine device

Question 21

Ulipristal acetate should betaken?

Answer 21

Within 120 hours.5 days

Higher BMI specifically

Question 22

High levels of progesterone cause?

Answer 22

Thickening of mucus, harder for embryo to implant

Question 23

Which preparation consistently inhibits ovulation?

Answer 23

Oral desogestrel

Question 24

Long acting progesterone depot?

Answer 24

Medroxyprogesterone acetate

Question 25

3 year rod in arm progesterone only?

Answer 25

Etonogestrel releasing implant

Question 26

What should testosterone be given in combination with?

Answer 26

Progestin to reduce side effects

Question 27

Rules about CHC?

Answer 27

Prescribe for 12 month supply

Don’t continue over 50 years, safer alternatives

Question 28

What is the role of oral desogestrel?

Answer 28

Inhibits ovulation

Question 29

Etonogestrel releasing implant?

Answer 29

Up to 3 years, rod under the arm

Question 30

What are the advantages of Mireya and Jayden over copper intra-uterine devices?

Answer 30

Improvement in any dysmenorrhoea and a reduction in blood loss

Possibly reduced PID

Question 31

If someone has a BMI of over 26kg/m2 then the emergency contraception would be?

Answer 31

Ulipristal acetate or double dose of levonorgestrel

Question 32

What should be combined with testosterone to minimise androgenic effects?

Answer 32

Progestin