Hormonal Contraception

Question 1

Contraception good how?

Answer 1

Spacing children

Recourse to abortion

Question 2

What is first line for contraception?

Answer 2

Increase use of long acting reversible contraceptive methods in Australia.

Question 3

What is LARC?

Answer 3

Long acting reversible contraception

Question 4

COC?

Answer 4

Oestrogen and progetagen

Question 5

COC main Mechanism of action?

Answer 5

1. No egg

2. Thicken cervical mucus

Question 6

Quick start method important how?

Answer 6

If excluded pregnancy

Question 7

Why get breakthrough bleed on COC?

Answer 7

Religion

Question 8

Do antibiotics interfere with COC?

Answer 8

Nope.

Only if vomiting or Diarrhoea

Question 9

Quick Start Method: LEARN FOR THE EXAM!

Answer 9

CRITERIA FOR EXCLUDING PREGNANCY.

Question 10

What is the Missed Pill Rule? COC?

Answer 10

Is it >24hours late?
Yes: take most recently missed straight away. Used condom for 7 days

No: take pill straight away, should still work.

Question 11

COC SFx?

Answer 11

Breast tenderness
Nausea
Breakthrough bleeding
Forgotten pills
Mood and libido changes
???weight

Question 12

Risks of COC?

Answer 12

VTE

May increase BP, AMI, stroke

Question 13

Contraindications for COC?

Answer 13

• Undiagnosed vaginal bleeding.
• Multiple risk factors
• Smoker >35
• Stroke
• known VTE
• migraine
• liver disease
• hormone dependent cancer
• drug interactions
• breastfeeding

Question 14

Nuvaring made of?

Answer 14

COC

Controlled release, stays in for the month

Question 15

when use? Progesterone alone?

Answer 15

FIRST LINE!

LARC!

Question 16

How to take POP?

Answer 16

Take pill EXACTLY the same time everyday.

-if >3 hours, condoms and abstain for 3 days.

Question 17

Depot Provera, how to inject?

Answer 17

Retract skin then give. ‘Z’ tract injection

Question 18

Main disadvantage of depo-Provera?

Answer 18

Can do anything for 3 months.
-delay in return of fertility
Need to return 3 monthly

Question 19

When is implanon not effective?

Answer 19

if enzyme inducing drugs. Carbamazepine
Improve pain but not menorrhagia
Depot Provera: less likely to bleed.

Question 20

Compare and contrast Depot and Implanon?

Answer 20

EXAM!!!!

Question 21

Disadvantage of implanon?

Answer 21

Unpredictable bleeding

Headache, acne, weight gain, scar

Question 22

Important for Implanon tell woman?

Answer 22

Adequate Counselling

Question 23

IUD failures?

Answer 23

Unrecognized expulsions

Question 24

Advantage of LNG-IUS?

Answer 24

Effective
Cost effective
No day to day action
Repaid reversible
Long lifespan
Reduces uterine blood loss
50% amenorrhoea at 12 months.

Question 25

Disadvantages of LNG-IUS

Answer 25

6 months of Mentrual disturbance, wear panty liner, it’s ok if you stop periods.
5% expulsion risk. More in nulliparous woman
-perforation
-pelvic infection - from previous STI/chlamydia

Question 26

Ectopic preg with IUD?

Answer 26

So Less likely to get pregnant in the first place.

Question 27

Contraindications for Mirena?

Answer 27

Hormone dependent cancer

Unexplained bleeding.