Contraception

Question 1

How do contraceptives effect mood?

Answer 1

Conflicting. Most studies suggest no effect on most women.

Question 2

What is the recommended structure for conception counselling?

Answer 2

1. Open question: “Do you have a sense of what is important to you about your method?”
2. Elicit informed preferences
   
   • How they are taken: pills, IUD, implant, injection
   • How often they are taken: “There are methods you take every day, every week, every month, every three months, or even less often. How do you feel about these different options?”
   • Efficacy
   • Effect on menstrual bleeding (including regularity and flow)
   • Other side effects
   • Noncontraceptive benefits
   • Privacy
   • Effect on future fertility
3. Discuss method characteristics

Question 3

How do the methods effect period heaviness?

Answer 3

Hormonal contraceptions make periods lighter (withdrawal bleed only), implant/injectables/IUS may stop them, copper IUD makes them heavier

Question 4

Which contraceptives contain estrogens

Answer 4

Pill, patch, and ring

Question 5

Which contraceptives help with acne?

Answer 5

The estrogen containing ones

Question 6

Which are the most effective (<1%) contraceptives?

Answer 6

Implant (0.05%), IUS (0.2%), IUD (0.8%), Male sterilisation (0.15%), Female sterilisation (0.5%)

Question 7

Which are the moderately effective (<10%) contraceptives?

Answer 7

Injection (6% typ./0.2% perfect), pill + patch + ring (9% typ./0.2% perfect)

Question 8

Which are the less effective (>10%) contraceptives?

Answer 8

Condom (21% typical/2% perfect use), diaphragm (12% typical/6% perfect)

Question 9

How effective are contraceptives with perfect use?

Answer 9

Implant (0.05%), Hormonal (all others): 0.2%, Condom (2%)

Question 10

How do combined OCs work?

Answer 10

Inhibit the midcycle gonadotropin surge and thus prevent ovulation + thickens cervical mucus

Question 11

How does progestogen only contraception work?

Answer 11

Contains lower doses of progestogens than COC, less reliably inhibits the midcycle gonadotropin surge but still thickens cervical mucus. Exception is IUS which reduces endometrium

Question 12

Absolute (UKMEC4) contraindications for eostrogen?

Answer 12

Vascular(Severe hypertension, prev. VTE, CHD, stroke), AF, migraine with aura, Over 35+smoking>15