Contraception

Question 1

what does the POP do to the female genitals?

Answer 1

thickens cervical mucus
reduces receptivity of the endometrium to implantation
inhibits ovulation

Question 2

when is the POP effective immediately?

Answer 2

day 1-5 of cycle, if not use condoms for 2 days

Question 3

what are progesterone side effects?

Answer 3

acne
bloating
breast tenderness
decreased sex drive
hirsutism
bleeding
wt gain 
mood swings/anxiety/depression

Question 4

in what conditions can progesterone only contraception not be used?

Answer 4

breast cancer
trophoblastic disease
liver disease
SLE
CVD - migraine +aura, stroke, IHD (while on progesterone pill)
crohns/malabsorption

Question 5

what hormone is in the depo injection?

Answer 5

progesterone

Question 6

when is depo injection given? how long does it last?

Answer 6

first 5 days of cycle, lasts 14 weeks

Question 7

what age cannot get the depo injection?

Answer 7

> 50yrs

Question 8

what does the injection increase your risk of?

Answer 8

osteoporosis

Question 9

what hormone does the implant use?

Answer 9

progesterone

Question 10

how long does the implant last?

Answer 10

3yrs

Question 11

when should the implant be inserted?

Answer 11

day 1-5, if not use condoms for 7 days

Question 12

what are the 3 types of coil and how long do they last?

Answer 12

copper 5-10yrs
mirena 5yrs
jaydess 3yrs

Question 13

when can copper coil be used as emergency contraception?

Answer 13

120hrs of UPSI or if >5 days since, up to 5 days after ovulation

Question 14

how do IUDs work?

Answer 14

inhibit implantation

Question 15

side effect of copper coil?

Answer 15

heavy periods

Question 16

side effects of jaydess/mirena?

Answer 16

lighter periods
less painful periods
spotting
heavy bleeding

Question 17

risks with IUD?

Answer 17

expulsion
PID
dysmenorrhoea
menorrhagia
ectopic

Question 18

what does COCP benefit?

Answer 18

decreases ovarian, endometrial and bowel cancer risk
blocks ovarian cyst formation
improves acne

Question 19

what are oestrogen side effects?

Answer 19

bloating
breast swelling/tenderness
decreased sex drive
fibroids
headaches
irregular bleeding
N+V
raised BP
wt gain

Question 20

with oestrogen and progesterone, why may wt gain occur?

Answer 20

oestrogen - water retention

progesterone - increased appetite

Question 21

who cannot have COCP?

Answer 21

more than 35 years old and smoking more than 15 cigarettes/day
migraine with aura
thromboembolic disease
history of stroke or ischaemic heart disease
breast feeding < 6 weeks post-partum
uncontrolled hypertension
current breast cancer
surgery and immobility

Question 22

what is the most effective emergency contraceptive?

Answer 22

ulipristal acetate (ella one)

Question 23

how long after UPSI can EllaOne be useD?

Answer 23

120hrs

Question 24

how does EllaOne work?

Answer 24

inhibits/delays ovulation

Question 25

when is EllaOne best taken in the cycle?

Answer 25

before LH surge (ideally more than 24hrs)

Question 26

contraindications for EllaOne?

Answer 26

breast feeding liver enzyme inducing drugs drugs reducing gastric pH

Question 27

when MUST levonorgestrel be given?

Answer 27

before LH surge (day 13)

Question 28

how long after UPSI can levonorgestrel be given?

Answer 28

72hrs post UPSI

Question 29

how does levonorgestrel work?

Answer 29

inhibits/delays ovulation

Question 30

how does lactational amenorrhoea occur?

Answer 30

high PRL levels during pregnancy (not masked by progesterone, once placenta is expelled) PRL inhibits GnRH which reduces oestrogen inhibits ovulation

Question 31

what does IUD pose risk of?

Answer 31

cervical shock

Question 32

if on OCP, when does a missed pill become dangerous? what must you do?

Answer 32

two or more | continue taking and use protection for 7 days

Question 33

risks of progesterone only contraceptives?

Answer 33

ovarian cysts | breast cancer

Question 34

what are stroke risk factors?

Answer 34

``` smoking obesity age >35yrs DM dyslipidaemia FHx of arterial disease <45yrs ```

Question 35

risks of COCP?

Answer 35

breast cancer | cervical cancer

Question 36

if getting the copper coil, when is it safe to have unprotected safe?

Answer 36

immediately

Question 37

what must be done before copper coil insertion?

Answer 37

STI screen | if not able to do this, azithromycin

Question 38

what must patients do to ensure IUD is not expelled?

Answer 38

feel the threads after each period

Question 39

how many days PP is a women protected for?

Answer 39

28 days