Contraception

Question 1

What are the three methods of combined hormonal contraception

Answer 1

Tablets patches and rings

Question 2

What age is too old for the combined contraception

Answer 2

50

Question 3

Name 7 health benefits of Combined hormones contraception

Answer 3

Reduced risk of ovarian endometrial and colorectal cancer
Predictable bleeding patterns
Reduced dysmenorrhea and menorrhagia
Management of symptoms of PCOS endometriosis and premenstrual syndrome
Improves acne
Reduced menopausal symptoms
Maintaining bone mineral density in perimenopausal females under 50yo

Question 4

What does the term monophonic and multiphase mean in relation to combined contraception

Answer 4

Monophasic - fixed amount of oestrogen and progesterone

Multiphasic - varying amounts of the two hormones

Question 5

What is the general dose of ethinylestradiol in the first line pill in combination with what type of progesterone

Answer 5

Monphasic 30micrograms in combination with levonorgestrel or norethisterone

Question 6

Ethinylestradiol is in … units

Answer 6

Micro grams

Question 7

Estradiol is in what units

Answer 7

Mg

Question 8

What are alternative ways to use the pill in terms of hormone free intervals

Answer 8

21 days in 4 days off
9 weeks on 4-7 days off
21 days on then 4 days off when breakthrough bleeding occurs
Continuous use with no hormone free days

Question 9

What should be checked annually on the pill

Answer 9

BP and BMI

Question 10

When should the pill be stopped and recommenced with surgery

Answer 10

Stop 4 weeks prior

Continue two weeks after

Question 11

How do oral progestogen only preparations work

Answer 11

Alter cervical mucous to prevent spleen penetration and may inhibit ovulation

Question 12

How do desogesterel only preps work

Answer 12

Inhibit ovulation

Question 13

What is the main reason for giving progesterone over combined pill

Answer 13

When oestrogen is contraindicated

Question 14

What is the medical name for Depo

Answer 14

Medroxyprogesterone acetate

Question 15

What may occur after discontinuation of depo

Answer 15

Delayed return of fertility and irregular cycles

Question 16

How long does it take for fertility to return after depo

Answer 16

3-6 months but can take up to a year

Question 17

Is the implant combined or progesterone

Answer 17

Progesterone

Question 18

How long does the implant work for

Answer 18

3 years

Question 19

IUS is

Answer 19

Progesterone only - levonorgestrel

Question 20

IUS how long does it take for fertility to return

Answer 20

Rapid

Question 21

Contraindications to combined contraceptives

Answer 21

Heart disease breast cancer hepatocellular carcinoma 
Known thrombophlebitis mutations 
Less than 6 weeks postpartum 
Migraine with aura
Previous or current VTE 
Stroke /TIA
PVD 
Smoking aged >35 
SLE
Be cautious with BRCA mutation 
BMI>35 
Cervical neoplasia

Question 22

Side effects of combined pills

Answer 22

Acne fluid retention weight gain headaches irregular bleeding nausea

Question 23

Which cancers does the pill increase the risk of

Answer 23

Breast

Cervical

Question 24

When does the risk of breast cancer diminish after the use of cocp

Answer 24

Disappears after 10 years of using the pill

Question 25

When do you get an increase in risk of cervical cancer

Answer 25

If using for longer than 5 years | Diminishes after 10 years

Question 26

Can you use cocp while breast feeding

Answer 26

Avoid until weaning or for 6 months after birth

Question 27

When can you start the pill after giving birth

Answer 27

3 weeks or 6 weeks with risk factors

Question 28

When can you start taking the pill

Answer 28

If starting on day six or later you need barrier protection for the first 7 days

Question 29

When is the critical time for loss of contraceptive protection

Answer 29

When a pill is omitted at the beginning or end of a cycle (which lengthens the pill free interval)

Question 30

If a woman misses a pill she should take it ..... and the next one taken .....

Answer 30

As soon as possible ..... taken at normal time even if it means taking two together

Question 31

When does a pill count as missed

Answer 31

If greater than 24 hours or later

Question 32

If 2 or more missed particularly in the first seven days .....

Answer 32

Barrier protection

Question 33

If two or more missed and barrier protection used for 7 days but the 7 days end up running beyond the end of the packet

Answer 33

Take the next packet immediately and don’t take a break

Question 34

What is the main contraindication for progesterone only pill

Answer 34

Acute porphyria | Breast cancer

Question 35

What is a suitable alternative contraception prior to surgery

Answer 35

Progesterone only pill