Contraception

Question 1

Mechanism of action of COCP

Answer 1

Stops ovulation and increase cervical mucus production.

Thins the endothelial lining too.

Can regulate periods and improve achne

Question 2

How to take the COCP

Answer 2

Every day for 3 weeks
Then one week off
ideally start on day on cycle or use condom for first 7 days

Question 3

Advice over missed COCP

Answer 3

Use the advice on the packaging
More than one, would say not covered and use barrier contraception
Take around the same time every day

Question 4

SE of COCP

Answer 4

Headaches
Nausea 
Mood changes 
Breast tenderness
These often resolve

Question 5

Contrindications to COCP

Answer 5

Migraine with aura
VTE hx
Smoke 35+
Breast feeding

Question 6

Action of progesterone only pill

Answer 6

Increases thickness of cervical mucus and thins endothelium

Question 7

How to take progesterone only pill

Answer 7

Take same time each day
Every day
Ideally start on day 1 of cycle or use barrier for 7 days

Question 8

Missed progesterone pill

Answer 8

Take straight away
>3 hrs use condom for 2 days

Consider emergency contraception of had sex 2-3 days before or after missed pill

Question 9

What does progesterone pill do to periods?

Answer 9

Can make lighter or even stop them.

Question 10

SE of progesterone only pill

Answer 10

Mood swings
Acne
Headache
Tender breasts

Question 11

Contraindications to progesterone only pill

Answer 11

Breast cancer
Undiagnosed PV bleed
Liver disease

Question 12

Mechanism of action of progesterone depo injection

Answer 12

Stops ovulation
Increased cervical mucus / thickens mucus
Thins endothelium

Question 13

How often is the depo injection given

Answer 13

every 3 m

Question 14

Hormonal SE for progesterone injection

Answer 14

Mood swings
weight gain 
acne 
headache 
tender breasts 
periods can be irregular

Question 15

contraindications for progesterone injection

Answer 15

cancer
liver disease
undiagnosed PV bleed

Question 16

How long can it take for fertility to return after progesterone injection stopped ?

Answer 16

18m

Question 17

Progesterone implant MOA

Answer 17

Stops ovulation

increased cervical mucus

thins endothelium

Question 18

How is the implant put in?

Answer 18

inserted under the skin
local anaesthetic

bleeding / bruising / infection / scarring

Question 19

SE of progesterone implant

Answer 19

mood swings 
weight gain 
acne 
headache 
tender breasts

Question 20

red flag after implant put in

Answer 20

red and sore arm
discharge
systemically unwell

Question 21

Mirena coil mechanism of action

Answer 21

progesterone

stops ovulation

increase cervical mucus

thins endothelium

Question 22

what needs to be checked before coil put in ?

Answer 22

STI check

Question 23

When are they covered by the coil straight away?

Answer 23

first 7 days of cycle

if not - condom for first 7 days

Question 24

How long does the mirena coil last for

Answer 24

3 - 5 years

Question 25

what happens to periods on mirena coil

Answer 25

lighter shorter less painful often get irregular bleeding or spotting

Question 26

how often check strings with the coil?

Answer 26

every 4 weeks

Question 27

red flags after coil insertion?

Answer 27

severe pain smelly discharge high temp

Question 28

Contraindications to the coil

Answer 28

``` PID <3m ago STI gynae cancer small uterine cavity undiagnosed PV bleed ```

Question 29

mechanism of action of the copper coil

Answer 29

spemicide and alters cervical mucus

Question 30

when does the copper coil start working?

Answer 30

straight away

Question 31

how long can the copper coil work for?

Answer 31

10 years

Question 32

coil impact on periods

Answer 32

can make heavier or more painful

Question 33

up to how long after sex can the levongestrel pill be used?

Answer 33

72 hrs

Question 34

up to how long after ellaone pill after sex?

Answer 34

120 hrs

Question 35

when cannot use ellaone if ?

Answer 35

previously used in a cycle

Question 36

impact of ellaone on starting contraception

Answer 36

may reduce efficacy

Question 37

emergency contraception q.

Answer 37

``` Sexual history – when? Who? Check consensual, is it a regular partner Current contraception Type Reason for failure Why they need emergency contraception LMP Cycle length Current day of cycle PMH: HTN, migraine with aura FH: VTE, stroke, migraine with aura SH: smoking, drinking Any possibility they could already be pregnant/ used emergency contraception in this cycle Symptoms of STI – vaginal discharge, bleeding, warts Smears up to date Future contraception options Risk of STIs Advice to take pregnancy test in 3 weeks Safety net for ectopic PMH ``` MEDICATION

Question 38

If start pill on day one of cycle - If not....

Answer 38

Don't need barrier contraception Need BC for 7 days

Question 39

medication in ellaone

Answer 39

ulliprestel

Question 40

copper coil mechanism of action in emergency

Answer 40

prevents implantation

Question 41

up to how long after sex can copper coil be put in?

Answer 41

5 days

Question 42

which emergency contraception not affected by hormonal contraception

Answer 42

levongestrel and copper coil

Question 43

how long do eggs last?

Answer 43

one day

Question 44

how long do sperm last?

Answer 44

5 days

Question 45

Which medication reduces efficacy of ellaone

Answer 45

PPI and ranitidine

Question 46

Within what time frame, if they vomit should they take the emergency pill?

Answer 46

2 hrs