Contraception

Question 1

what is LARC

Answer 1

long acting reversible contraception

Question 2

what are the main types of LARC available

Answer 2

IUD
IUS
implant

Question 3

what are the main types of non-LARC available

Answer 3

contraceptive pills
barrier methods such as condoms, rings and diaphragm
injection
sterilisation

Question 4

list the difference mechanisms of action contraception methods have

Answer 4

prevent ovulation by suppressing LH and FSH
prevention of fertilisation by toxicity
prevention of implantation by increasing mucus and making the endometrium hostile

Question 5

list the non-contraceptive benefits of hormonal contraception

Answer 5

reduce all of:
heavy bleeding
irregular bleeding 
PMS
ovarian cysts
ovarian/endometrial cancer 
acne and hirsutism if on CHC

Question 6

which methods have a lower failure rate, LARC or non-LARC

Answer 6

LARC as the difference between the best and most common way to take it is very small. non-LARC has more chance of error

Question 7

what are the contraindications for IUD/IUS

Answer 7

submucosal fibroids
uterine malformation
any other uterine pathology

Question 8

which type of IUD/IUS is non-hormonal and what is a dis-advantage to it

Answer 8

copper coil is non-hormonal

disadvantage can make periods heavier and more painful in first few months

Question 9

what are some risks associated with insertion of IUS/IUD

Answer 9

small risk of perforation and expulsion following insertion

Question 10

what are the 4 different types of IUS

Answer 10

marina
levosert
kyleena
jaydess

Question 11

what non-contraceptive benefit does the Marina coil have

Answer 11

licensed to treat heavy bleeding and help with heavy periods. 50% have amenorrhoea 6 months after insertion

Question 12

what is the depo provera

Answer 12

contraceptive injection which is a progestogen only method

Question 13

what are the contraindications of the deop provera

Answer 13

very few except known breast or gynaecological malignancy

Question 14

what is the main side effect of the depo provera

Answer 14

prolonged PV bleeding - unpredictable
weight gain
homonal s/e such as nausea, spots, headaches

Question 15

what are the three methods of combined hormonal contraception

Answer 15

pill
patch
ring

Question 16

describe the cycle of taking the COCP

Answer 16

take 1 pill for 21 days then have 7 day break for withdrawal bleed then repeat. can run up to three packs together before stopping for bleed

Question 17

when is it safe to begin the COCP

Answer 17

can begin it within first 5 days of period and immediately protected or any other time throughout cycle and use other method of contraception for 7 days

Question 18

what factors can affect the effectiveness of COCP

Answer 18

impaired absorption eg GI conditions
increased metabolism such as liver enzyme inducers eg Carbamazepine
forgetting to take pill

Question 19

list some of the main risks of CHC

Answer 19

venous thrombosis
hypertension -> MI and stroke if high risk
increased breast cancer risk

Question 20

list the main side effects of CHC

Answer 20

nausea
spots
breast tenderness
bleeding

Question 21

list the main contraindications of CHC

Answer 21

smoking
BMI >30
>40 years old
Hx of VTE, stroke, AF

Question 22

COCP is protective against which cancers

Answer 22

ovarian, endometrial and cervical due to switching off of ovulation

Question 23

how does POP work

Answer 23

thickens cervical mucus to inhibit implantation

Question 24

hoe does COCP work

Answer 24

prevent follicular development which inhibits ovulation

Question 25

what are the contraindications to POP

Answer 25

breast cancer in last 5 years

liver disease

Question 26

when can you start using POP

Answer 26

within first 5 days of period, immediately protected or any other time of cycle and use condoms for 2 days

Question 27

what is the routine of taking POP

Answer 27

take 1 pill every day at the same time for 3 weeks, if forget within 12 hours unprotected for 2 days, 1 week off to bleed

Question 28

what type of drugs can interact with COCP and POP

Answer 28

liver enzyme inducers making pill ineffective

Question 29

what is nexplanon

Answer 29

a progestogen only implant rod that offers contraception for 3 years

Question 30

does the depo provera interact with liver enzyme inducers

Answer 30

no - therefore best method in women with epilepsy

Question 31

what is one of the risks of using the depo in teenage girls as a contraceptive method

Answer 31

reduced bone density and this can result in overall lower peak bone density -> risk of osteoporosis

Question 32

what are the side effects of the implant

Answer 32

hormonal side effects

changes in bleeding - some can have amenorrhoea

Question 33

list the 3 methods of emergency contraception

Answer 33

copper IUD
ellaOne
Levonelle

Question 34

which is the most effective method of emergency contraception

Answer 34

copper IUD

Question 35

what criteria must be met to have a copper IUD fitted in an emergency

Answer 35

within first 5 days of period

or within 5 days of single episode of sex

Question 36

what is the mechanism of action of ellaOne

Answer 36

blocks progestogen receptors, stops LH surge which suppresses ovulation

Question 37

how many days can ellaOne be taken after intercourse

Answer 37

up to 5 days after but most effective asap

Question 38

what is the mechanism of action of Levonelle

Answer 38

high dose of progestogen, aims to inhibit ovulation

Question 39

how many days can levonelle be taken after intercourse

Answer 39

3 days but take asap

Question 40

when is levonelle less effective in a womens cycle

Answer 40

towards the end of the cycle if already ovulated

Question 41

both oral methods of emergency contraception are affected by liver enzyme inducers true/false

Answer 41

true