Contraception

Question 1

What are the methods of contraception?

Answer 1

Barrier
Daily
Long acting reversible
Long acting irreversible

Question 2

What are some methods of barrier contraception?

Answer 2

Condom
Femidom
Diaphragm

Question 3

What are some daily methods oc contraception?

Answer 3

Combined OCP

Progesterone only pill POP

Question 4

What are some long acting reversible methods of contraception?

Answer 4

Implant
Injection
IUS
IUD

Question 5

How does the combined pill work?

Answer 5

Inhibits ovulation

Question 6

What are some advantages of combined pill?

Answer 6

Period control- can take 3 packs back to back then take 4 or 7 day break- more likely to result in breakthrough bleeding

Question 7

What are some disadvantages of combined pill?

Answer 7

Increased risk VTE, breast and cervical cancer

Made ineffective by antibiotics and enzyme inducing drugs

Question 8

What are the absolute contraindications to the combined pill?

Answer 8

Migraine with aura
PMH thromboembolism
PMH strke/IHD
Uncontrolled hypertension
Current breast cancer
MAjor surgery within 4 weeks
Breastfeeding and <6 weeks postpartum
>35yo smoking >15/day

Question 9

What are some instances where the combined pill is not recommended?

Answer 9

BMI >35
FH thromboembolism in <45yo
Controlled hypertension
Current gallbladder disease
BRCA 1 or 2 
Immbolity
>35yo smoking <15/day

Question 10

What do you do will 1 missed poll combined OCP?

Answer 10

Take when you remember, even if it means taking 2 at once

No extra precautions necessary

Question 11

What do you do when you miss 2 combined pills?

Answer 11

Take 2 pills at once then continue as normal

Use additional methods for 7 days

Question 12

How does the POP work?

Answer 12

Thickens cervical mucus

Desogestrel- thickens cervical mucus and inhibits ovulation

Question 13

What are the advantages of the POP?

Answer 13

No absolute contraindications
Can stop periods entirely
No oestrogen
Effective wthin 2 days

Question 14

What are the disadvantages of the POP?

Answer 14

Must be taken within 3 hour (or 12 for desogestrel) window daily

Question 15

How does the implant work?

Answer 15

Primary= inhibits ovulation
Secondary= thickens cervical mucus

Question 16

What are the advantages of the implant?

Answer 16

Lasts 3 years
No oestrogen
Lower hormone dise

Question 17

What is a disadvantage of the implant?

Answer 17

Irregular bleeding

Need trained professional t insert

Question 18

What is the injection?

Answer 18

Depo-Provera

Injection every 12 weeks

Question 19

What is the method of Depo-Provera?

Answer 19

Primary= inhibit ovulation
Secondary= thicken cervical mucus

Question 20

What are some disadvantages of the injction?

Answer 20

Weigh gain
Bone density decrease
Return to fertility can take ~1 year

Question 21

What is the method of action of the IUS?

Answer 21

Primary= prevents endometrial proliferation
Secondary= thickens cervical mucus

Question 22

What are some advantages of the IUS?

Answer 22

Long term

1st line management of dysmenorrhoea

Question 23

What are some disadvantages of the IUS?

Answer 23

Irregular bleeding

Question 24

How does the IUD woek?

Answer 24

Decreased sperm motility and survival

Question 25

What are some advantages of the IUD?

Answer 25

Can be inserted any time Can be used as emergency contraception Hormone free Long term

Question 26

What are some disadvantages of the IUD?

Answer 26

Can make periods longer, heavier and more painful

Question 27

What is the failure rate of sterilisation?

Answer 27

1 in 200

Question 28

What are some disadvantages of sterilisation?

Answer 28

Major operation General anaesthetic usually Reversal complicated and rarely works

Question 29

What is the failure rate of vasectomy?

Answer 29

1 in 2000

Question 30

What are some complications of vasectomy?

Answer 30

Bruising infection Sperm granuloma Chronic testicular pain

Question 31

What is the % success of vasectomy reversal?

Answer 31

<10 years= 55% | >10 years= 25%

Question 32

What are the options for emergency contraception?

Answer 32

Levonorgestrel= levonelle Ulipristal acetate= ellaOne IUD

Question 33

When can levonorgestrel be taken?

Answer 33

Within 72 hours | Efficacy decreases with time

Question 34

What is the dose of levonelle?

Answer 34

Single dose 1.5mg | -double dose if BMI >26 or >70kg

Question 35

What are some advantages of levonelle?

Answer 35

Can be used more than once per menstrual cycle Doesn't interfere with other hormonal contraception Can be used while breastfeeding

Question 36

When can ellaOne be taken?

Answer 36

Within 120 hours | Efficacy doesn't decreae with time

Question 37

What is the dose of ellaOne?

Answer 37

Single dose 30mg

Question 38

What are some disadvantages of ellaOne?

Answer 38

Can interfere with other hormonal contraception for 5 days | Cannot be used while breastfeeding

Question 39

When can the IUD be used as emergency contraception?

Answer 39

Within 5 days or 5 days after likely date of ovulation | Can remain in situ as long term contraception

Question 40

When is contraception required postpartum?

Answer 40

After 21 days

Question 41

When can the POP be started postpartum?

Answer 41

From day 21

Question 42

When can the combined pill be started post partum?

Answer 42

Breastfeeding= absolute contraindication until 6 weeks, not preferred until 6 months Not breastfeeding= day 21

Question 43

When can the IUS/IUD be used postpartum?

Answer 43

Within 48 hours or after 4 weeks

Question 44

When can contraception be stopped in menopausal women?

Answer 44

``` <50= 2 years of amenorrhoea >50= after 1 years amenorrhoea ```

Question 45

What contraceptive options can <50s use?

Answer 45

All available

Question 46

What contraceptive options are contraindicatd in >50s?

Answer 46

Combined OCP | Depo-Provera

Question 47

What contraceptive options are there for >50s?

Answer 47

Implant POP IUS IUD