Contraception

Question 1

Give the mode of action for COCP

Answer 1

Inhibits ovulation

opposes oestrogen effects of endometrial proliferation

Question 2

Give the mode of action for POP (excluding desogestrel)

Answer 2

thickens cervical mucus

Question 3

Give the mode of action for desogestrel only POP

Answer 3

Primary: inhibits ovulation

Also thickens cervical mucus

Question 4

Give the mode of action for Depot, what hormone does it have

Answer 4

Primary: inhibits ovulation
Also: thickens cervical mucus
Medroxyprogesterone acetate

Question 5

Give the mode of action for IUD

Answer 5

decreases sperm motility and survival

inhibits implantation

Question 6

Give the mode of action for IUS

what is it also know as

Answer 6

Primary: prevents endometrial proliferation
also: thickens cervical mucus

Question 7

How does levonorgestrel work

Answer 7

inhibits ovulation

Question 8

how does ulipristal work, what contraceptive is it?

Answer 8

Ella one - morning after pill

Inhibits ovulation

Question 9

What is the age of consent?

Answer 9

16

Question 10

Give the Fraser guidelines?

Answer 10

• understands advice
• cannot be persuaded to tell parents
• likely to continue having unprotected sex
• physical, MH likely to suffer from no rx
• their best interests

Question 11

What are long acting reversible contraceptives?

Answer 11

implant
injection
IUS - levonorgestrel
IUD

Question 12

What are short acting reversible contraceptives?

Answer 12

COCP
POP
Combined transdermal patch
Combined contraceptive vaginal ring

Question 13

What is the failure rate of POP

Answer 13

0.3%

Question 14

What is the failure rate of Depo

Answer 14

0.2%

Question 15

What is the failure rate of the implant

Answer 15

0.05%

Question 16

What are adverse effects of progesterone only contraceptives?

Answer 16

Menstrual irregularities
Breast tenderness
Ovarian cysts
increased risk of breast cancer

Question 17

What is the failure rate of COCP

Answer 17

0.3%

Question 18

What are barrier methods of contraception

Answer 18

Male and female condoms.
Diaphragms and caps.
Spermicides.

Question 19

Why are condoms w pre-lubricated spermicide not recommended?

Answer 19

increase transmission of blood-borne infections such as HIV, hep b/c

Question 20

What are advantages of male condoms

Answer 20

Protect against STIs and cervical cancer

Question 21

What are disadvantages of male condoms

Answer 21

less effective
can break and slip off
interrupts sex
loss of sensitivity

Question 22

What are advantages and disadvantages of female condoms?

Answer 22

Adv:
reduce risk of some STIs + CC
disadvantages:
can be dislodged or penis inserted in wrong bit 
noisy

Question 23

What is failure rate w typical use of male condom?

Answer 23

18%

Question 24

What is failure rate w perfect use of male condom?

Answer 24

2%

Question 25

What is a disadvantage of diaphragms?

Answer 25

may not reduce risk of STIs

Question 26

How should a woman be started on COCP?

Answer 26

day 1 of the menstrual cycle

Question 27

What are advantages of COCP

Answer 27

Lighter, regular less painful periods, | reduced risk of ovarian, endometrial cancer

Question 28

What does the implant contain?

Answer 28

etonogestrel

Question 29

What is failure rate of IUS

Answer 29

0.2%

Question 30

What is failure rate of IUD?

Answer 30

0.8%

Question 31

If a woman has IUS and PID, what is management

Answer 31

don't need to remove IUS, can test for organism and start abx treatment

Question 32

How long can IUS stay in?

Answer 32

3-5 years

Question 33

What is a disadvantage of IUS?

Answer 33

acne headaches and unscheduled bleeding in the first 3-6months of using it

Question 34

When does lactational amenorrhoea method work?

Answer 34

<6m post-partum if fully breastfeeding has to be amenorrhoeic

Question 35

Which contraceptive has evidence for weight gain?

Answer 35

the injection

Question 36

Which contraceptive causes a delay in returning to fertility after stopping?

Answer 36

injection

Question 37

Which contraception requires monitoring of BMD and when

Answer 37

Depot when under <18yr due to association with reduction in BMD

Question 38

What are options for emergency contraception?

Answer 38

Progesterone pill - Ellaone or Levonelle | IUD

Question 39

When can IUD be used as emergency contraception?

Answer 39

within first 5 days

Question 40

What does Ellaone contain?What is the window for which it can be used as emergency contraception?

Answer 40

ulipristal acetate | 120hr

Question 41

What does Levonelle contain? What is the window for which it can be used as emergency contraception?

Answer 41

levonorgestrel | 72 hrs

Question 42

What are permanent methods of contraception?

Answer 42

Vasectomy | Tubal occlusion

Question 43

Which permanent method can be reversed? what are success rates?

Answer 43

vasectomy AND occlusion! 40-97% for vasectomy 31-92 for occlusion

Question 44

when are vasectomys confirmed as effective?

Answer 44

12 weeks to confirm azoospermia

Question 45

What does tubal occlusion increase the risk of ?

Answer 45

ectopic pregnancies

Question 46

What is lifetime failure rate of occulsion

Answer 46

1 in 200