Contraception

Question 1

What are the main types of contraception?

Answer 1

Combined hormonal
Progesterone only
IUS
IUD
Barrier methods
Natural methods
Emergency contraception

Question 2

Combined hormonal contraception contains which hormones?

Answer 2

Oestrogen and progestogen

Question 3

What is the main effect of combined hormonal contraception?

Answer 3

Inhibits ovulation

Question 4

For how long does the contraceptive implant work?

Answer 4

Up to 3 years

Question 5

What is the main mode of action of the implant?

Answer 5

Inhibits ovulation

Question 6

What is the main mode of action of the intrauterine system?

Answer 6

Affects implantation - renders endometrium unfavourable for implantation

Question 7

What is the main mode of action of the intrauterine device?

Answer 7

Prevents fertilisation

Question 8

What is involved in female sterilisation?

Answer 8

The fallopian tubes are blocked

Question 9

What is involved in male sterilisation?

Answer 9

The vas deferens is cut

Question 10

What examinations are done before prescribing LARC?

Answer 10

BMI
Blood pressure
Smear status
PV

Question 11

Give some indications that a women is not currently pregnant

Answer 11

No sex since last period
Consistently using reliable contraception
<7 days since last normal period
<4 weeks post partum
Fully breastfeeding/amenorrhoeic

Question 12

What are the three methods of emergency contraception?

Answer 12

Copper IUD
LNG-EC (levonelle)
UPA-EC (EllaOne)

Question 13

When can emergency contraception be used?

Answer 13

Up to 5 days after UPSI

Within 5 days of predicted ovulation

Question 14

What is the most effective method of emergency contraception?

Answer 14

Copper IUD

Question 15

How does the copper IUD work?

Answer 15

Toxic to sperm/ovum

Anti-implantation

Question 16

When can the Cu IUD be inserted?

Answer 16

Up to 120 hours post-UPSI

Up to 5 days after earliest expected date of ovulation

Question 17

How does oral emergency contraception work?

Answer 17

Delay ovulation by affecting progestogen levels

Question 18

For how long can LNG-EC be used post-UPSI?

Answer 18

72 hours

Question 19

For how long can UPA-EC be used post UPSI?

Answer 19

120 hours

Question 20

UPA is how effective across 5 days?

Answer 20

85%

Question 21

How does the effectiveness of LNG change?

Answer 21

~85% in first 24hrs

Reduces to approx 58%

Question 22

LNG works before/during/after LH surge

Answer 22

Before

Question 23

UPA works before/during/after LH surge

Answer 23

Works during but not after peak

Question 24

What are the three methods of combined hormonal contraception?

Answer 24

Oral contraceptive pill
Transdermal patch
Vaginal ring

Question 25

How is the COC taken?

Answer 25

Taken daily for 21 days followed by a 7 day break

Question 26

Give some factors that may affect effectiveness of CHC

Answer 26

Impaired absorption Impaired metabolism Non-compliance

Question 27

Give some unwanted effects of CHC

Answer 27

``` VTE Liver enzyme induction Systemic hypertension Arterial disease Increased risk of breast/cervical cancer ```

Question 28

Why should CHC not be prescribed in migraine with aura patients?

Answer 28

As it increases the risk of ischaemic stroke

Question 29

Give some non-contraceptive benefits of CHC

Answer 29

Reduction in ovarian cancer risk | Reduction in acne

Question 30

When can an IUS be started?

Answer 30

Anytime in cycle if no UPSI in past three weeks

Question 31

How does the DepoProvera injection work?

Answer 31

Given as an injection every 3 months to supress FSH