Contraception

Question 1

What is the main method of most hormonal contraception methods?

Answer 1

prevention of ovulation

Question 2

what does emergency hormonal contraception do in terms of ovulation?

Answer 2

temporarily delays ovulation

Question 3

condom mechanism of action

Answer 3

prevention of fertilisation - barrier contraception

Question 3

main mechanism of action of the LNG-IUS

Answer 3

prevention of fertilisation - thickening of the cervical mucus, which blocks sperm access to the upper genital tract

Question 4

what does LNG-IUD stand for?

Answer 4

levonorgestrel intrauterine device (hormone “coil”)

Question 4

what does POP stand for?

Answer 4

progestogen-only pill (“mini pill”)

Question 5

what does SDI stand for?

Answer 5

subdermal contraceptive implant (Nexplanon®) (“the rod”)

Question 6

what does COC stand for?

Answer 6

combined oral contraceptive pill (“the pill”)

Question 7

what does CTP stand for?

Answer 7

combined transdermal patch (Evra®)

Question 8

what does CVR stand for?

Answer 8

combined vaginal ring (NuvaRing®)

Question 9

what does Cu- IUD stand for?

Answer 9

copper intrauterine device (copper “coil”)

Question 10

which contraceptive methods suppress ovulation?

Answer 10

• combined hormonal contraception (CHC)
• depot medroxyprogesterone acetate (DMPA)
• subdermal contraceptive implant (SDI) - “the rod”
• lactational amenorrhoea method (LAM)
• modern POP (progesterone only pill)
• (LNG-IUD)

Question 11

which contraceptive methods thicken cervical mucous?

Answer 11

• LNG-IUD
• DMPA
• POP
• SDI (the rod)

Question 12

which contraceptive methods work by “tubal” occlusion?

Answer 12

• tubal ligation
• vasectomy

Question 13

which contraceptive methods work by direct toxic effect?

Answer 13

• Cu-IUD
• spermicides

Question 14

which contraceptive methods work by mechanical barrier?

Answer 14

External +
internal
condoms,
diaphragms,
cervical caps

Question 15

which contraceptive methods work by endometrial changes?

Answer 15

• Cu- and LNGIUD
• SDI (the rod)
• DMPA
• POP
• CHC (combined hormonal contraceptive)

Question 16

what does LARC stand for?

Answer 16

long acting reversible contraception

Question 17

how long after sex can copper coil be used as emergency contraception?

Answer 17

Up to 5 days after sex or 5 days after the earliest estimated day of ovulation

Question 18

what is the most effective contraceptive method?

Answer 18

subdermal contraceptive implant (SDI) - rod

Question 19

what is the main side effect of the SDI (rod)?

Answer 19

prolonged PV bleeding

Question 20

what is the UK MEC?

Answer 20

UK Medical Eligibility Criteria for Contraceptive Use

Question 21

what treatments are included in “combined hormonal contraception”?

Answer 21

• combined pill
• combined patch
• combined ring

Question 22

risks of combined hormonal contraception

Answer 22

• venous thromboembolism
• arterial disease - MI, stroke
• cancer risks

Question 23

which contraception is contraindicated in migraines WITH aura (a change occurring before the migraine)

Answer 23

combined hormonal

Question 24

what examinations are done before combined hormonal contraception?

Answer 24

BP BMI Check smear test if relevant check UKMEC

Question 25

what cancers do you get increased risk and which do you get reduction in risk on combined hormonal contraception?

Answer 25

breast and cervical - increased risk ovarian and endometrial - reduced risk

Question 26

why can combined hormonal therapy reduce functional ovarian cysts?

Answer 26

because you're not ovulating every month and stimulating the follicular development

Question 27

side effects of combined hormonal contraception

Answer 27

nausea skin changes - spots better or worse unscheduled bleeding breast tenderness low mood

Question 28

what's the main mechanism of action of POP?

Answer 28

inhibits ovulation

Question 29

are POP contraindicated in breast cancer?

Answer 29

yes

Question 30

what do depo provera and sayana press do?

Answer 30

Suppress FSH and stop ovulation Lower oestradiol levels

Question 31

depo provera and sayana side effects

Answer 31

weight gain nausea spots bleeding headaches

Question 32

what are diaphragms used alongside?

Answer 32

spermicide

Question 33

what emergency contraceptives are available?

Answer 33

- levonorgestrel (Levonelle) - Ulipristal acetate (Ella one) - Intrauterine device

Question 34

what type of hormone is levonorgestrel?

Answer 34

progesterone

Question 35

how does levonorgestrel work as emergency contraception

Answer 35

delays ovulation

Question 36

how does ulipristal acetate (Ella one) work as emergency contraception?

Answer 36

delays ovulation by postponing the LH surge

Question 37

what is the most effective emergency contraceptive?

Answer 37

intrauterine device