Lecture 7 - Contraception

Question 1

combined contraceptives

Answer 1

prevent ovulation by suppressing gonadotrophins

inhibit follicular development.

Question 2

taking the combined pill

Answer 2

failure rate 0.3-4
oestrogen and progesterone
taken 21 out of 28 days
prevents ovulation - thickens cervical mucous
reduces endometrial receptivity
caution with smoking and obesity

Question 3

evra contraceptive patch

Answer 3

failure - less than 1 %
combined
worn 3 weeks out of 4
prevents ovulation

Question 4

Nuvaring combined ring

Answer 4

combined
flexible and easy to insert and remove
worn for 3 weeks and discarded
new ring inserted 1 week later

Question 5

progestogen only pill

Answer 5

failure 0.5-4%
progesterone
one per day
thicken cervial mucus
requires accurate pill taking
irregular bleeding

Question 6

injectables

Answer 6

progesterone
depo provera, sayana press, noristerat
IM or SC every 8 or 12 weeks
no periods

Question 7

implanon

Answer 7

implant under skin
progesterone
lasts 3 years
irregular bleeding pattern

Question 8

IUS - Intrauterine system

Answer 8

progesterone
lasts 5 years
reduces/stops periods

Question 9

intrauterine device or coil

Answer 9

copper
prevents fertilisation by direct effect on sperm
endometrial changes due to foreign body
lasts 5-10 years
can cause heavy periods

Question 10

condoms

Answer 10

failure rate 2-15%
male and female
protect against STI's
double dutch
usually latex

Question 11

caps and diaphragms

Answer 11

failure - 4-8%
usually latex
usually left in for 6 hours and used with spermicide
some protection against STI’s

Question 12

Sterilisation

Answer 12

male - vasectomy
late recanalisation

female - tubal occlusion/ligation
failures - higher risk of ectopic pregnancy
mirena coil is as good

Question 13

Emergency oral contraception

Answer 13

2 oral preps - ulipristal and levonorgestrel
effective if taken promptly
delay ovulation
available without prescription
best emergency - IUD