Contraception

Question 1

Possible advantages of COC

Answer 1

• Reduced risk of endometrial, ovarian and colorectal cancer
• Predictable bleeding patterns
• Improvement of acne
• Reducing menopausal symptoms
• Reduced menorrhagia and dysmenorrhoea
• Management of PCOS, endometriosis and premenstrual syndrome
• Reduced menopausal symptoms

Question 2

WHEN TO STOP COC

Answer 2

• Sudden severe chest pain
• Sudden breathlessness
• Unexplained swelling or severe pain in one leg
• Severe stomach pain
• Serious neurological effects
• Hepatitis, jaundice, liver enlargement
• Systolic BP >160, diastolic below 95
• Prolonged immobility after surgery or leg injury

Question 3

Risk of venous thromboembolism - use with caution but avoid if two or more of:

Answer 3

1) Family hx in first degree relative aged under 45 years
2) Obesity (avoid if BMI >35kg)
3) Long term immobilisation (avoid if bed bound)
4) Hx of superficial thrombophelbitis
5) Age over 35 (avoid if over 50)
6) Smoking

Question 4

Side effects of COC

Answer 4

1) BREAST CANCER
2) CERVICAL CANCER

Question 5

When is the risk of losing contraceptive protection highest when a pill is missed

Answer 5

At the start or end of cycle

Question 6

What is a missed pill

Answer 6

One which is 24 hrs late

Question 7

What to do if you miss one pill

Answer 7

Take an active pill ASAP then resume as normal (even if means taking 2 at once). No additional precautions are necessary

Question 8

What to do if you miss 2 pills (especially in first 7)

Answer 8

Take an active pill ASAP and then resume normal pill taking regimen. In addition either abstain or use condoms for next 7 days. If these 7 days run beyond the end of the packet, the next packet should be started at once, omitting the pill free interval.

Question 9

When is EC recommended

Answer 9

If there has been 2+ missed COC from the first 7 days of the packet

Question 10

Diarrhoea and vomiting

Answer 10

If occurred in first 2 hours when taking COC take another
If persistent or severe lasting more than 24hrs, use additional contraception for 7 days after recovery. If occurred in the last 7 tablets, the next pill free interval should be omitted.

Question 11

POP

Answer 11

Use when COC is CI
- Venous thrombosis or a past hx
- Heavy smokers
- Hypertension above 160 or 95
- Valvular heart disease
- Diabetes
- Migraine with aura

Question 12

Levonelle timeframe

Answer 12

72 hrs

Question 13

ELLAONE timeframe

Answer 13

5 days

Question 14

IUD timeframe

Answer 14

can be inserted up to 5 days after UPSI.