Contraception

Question 1

How do LARCs block pregnancy?

Answer 1

Ovulation prevention

Question 2

What role does emergency contraception play?

Answer 2

Acts to delay ovulation.

Question 3

Is withdrawal an effective method of contraception?

Answer 3

No

Question 4

Which form of contraception is contraindicated in those who suffer from migraines?

Answer 4

Combined OC pill

Question 5

What is the most effective form of contraception?

Answer 5

Nexplanon (subdermal implant)

Question 6

Which contraception can be used as an emergency contraception aswell as a LARC?

Answer 6

Copper coil

Question 7

What is a LARC?

Answer 7

A long-acting reversible contraception.

Question 8

How long do coils (IUDs) work for?

Answer 8

3-10 years

Question 9

In what patients are coils unsuitable?

Answer 9

Those with fibroids or a uterine malformation.

Question 10

What are potential side-effects of a copper coil?

Answer 10

Heavier periods
Longer periods
More painful periods

Question 11

What may be given to treat copper coil side-effects?

Answer 11

NSAIDs

Question 12

Are intrauterine systems more effective than coils (also called IUDs)?

Answer 12

Yes

Question 13

What is an example of an intrauterine system?

Answer 13

Mirena coil

Question 14

What is different about an IUS compared to an IUD?

Answer 14

An IUS is a hormonal therapy - no hormones involved in an IUD.

Question 15

What can a mirena coil be used to treat?

Answer 15

Heavy periods

Question 16

What is the main side-effect of nexplanon?

Answer 16

Unpredictable post-vaginal bleeding.

Question 17

What can be given to control the side-effects of the implant?

Answer 17

Concurrent combined OC pill.

Question 18

What are the LARCs?

Answer 18

IUD
IUS
Implant

Question 19

What are the hormonal non-LARCs?

Answer 19

Combined OC pill
Vaginal ring
The patch

Question 20

When should the combined OC pill be initiated?

Answer 20

In the first 5 days following a period.

Question 21

If combined OC is started mid-cycle, how long will it take to work?

Answer 21

7 days.

Advise to use alternative contraception within this timeframe.

Question 22

How should the combined OC be taken?

Answer 22

Take for 21 days, then stop for 1 week.

Will have withdrawal bleed in the week between.

Question 23

What is the main determinant in oral contraceptive effectiveness?

Answer 23

Compliance

Question 24

What is of increased risk when taking the OC pill?

Answer 24

Thrombosis

Cancer (both breast and cervical)

Question 25

Can the combined OC pill raise blood pressure?

Answer 25

Yes Monitor closely if initiating at a high BP.

Question 26

Why is migraine with aura a contraindication of the combined OC?

Answer 26

Increased risk of ischaemic stroke.

Question 27

What is an aura?

Answer 27

A change preceding a headache by 5-20 minutes. Produces altered sensation - it is commonly visual.

Question 28

Which contraception decreases the risk of both ovarian and endometrial cancer?

Answer 28

Combined OC pill

Question 29

What should be tested prior to prescribing a combined OC pill?

Answer 29

BP BMI Check smear status Consider risk factors (if applicable)

Question 30

What is first-line treatment in PCOS?

Answer 30

Combined OC pill

Question 31

How does desogestrel (POP) work?

Answer 31

Inhibits ovulation | Thickens cervical mucus

Question 32

Why may POP be preferred to a combined OC pill?

Answer 32

Fewer adverse effects

Question 33

When is POP contraindicated?

Answer 33

Patients with breast cancer

Question 34

What is depo provera?

Answer 34

Progesterone injection

Question 35

What is a diaphragm?

Answer 35

A barrier method inserted prior to sex and removed after sex.

Question 36

What is an adverse effect of progesterone injection?

Answer 36

Can affect bone mass density.

Question 37

How is vasectomy success confirmed?

Answer 37

Semen sample with no sperm.

Question 38

Is vasectomy effective?

Answer 38

Yes - 0.05% failure rate.

Question 39

What is more effective - male or female sterilisation?

Answer 39

Male sterilisation

Question 40

What is the first-line emergency contraceptive?

Answer 40

Copper IUD

Question 41

What are the 3 forms of emergency contraception?

Answer 41

Copper IUD Ellaone Levonelle

Question 42

How quickly must emergency contraception be taken following unprotected sex?

Answer 42

Copper IUD insertion or Ellaone can be taken within 5 days of sex. Levonelle must be taken within the first 72 hours.

Question 43

Is vasectomy reversible?

Answer 43

No

Question 44

What are examples of contraceptives that act by inhibiting fertilisation?

Answer 44

Condoms | Diaphragm

Question 45

What guideline is referred to when assessing a minor (<16yo) presenting with a sex issue?

Answer 45

Fraser guidelines

Question 46

What is spermicide?

Answer 46

A substance that is toxic to sperm, killing it off.

Question 47

How long should a diaphragm be left in following sex?

Answer 47

6 hours

Question 48

How does ellaone work?

Answer 48

Delays the LH surge - hence delaying ovulation.

Question 49

What form of contraception is ineffective when ellaone is taken?

Answer 49

Progesterone-containing treatments. This is due to ellaone being a progesterone receptor blocker.

Question 50

Aside from compliance, what other factors affect contraceptive pill efficacy?

Answer 50

Concurrent enzyme-inducing drug therapy | Vomiting