contraception and birth control

Question 1

what are the barrier methods

Answer 1

condoms and female condoms- they are the only way to prevent the spread of STI as well as preventing pregnancy.

Question 2

what is the combined pill?

Answer 2

contains both oestrogen and progesterone. commonly known as “the pill”
taken daily for 3 weeks followed by a 7 day break

Question 3

what is the progesterone only pill?

Answer 3

contains just progesterone
taken everyday with no break

Question 4

what is the contraceptive vaginal ring?

Answer 4

a soft flexable plastic ring that goes into the vagina. it releases the hormones oestrogen and progesterone into the bloodstream.
it is replaced every 4 weeks- worn for 3 and then taken off for one week.

Question 5

what is the contraceptive patch?

Answer 5

patch that releases hormones oestrogen and progesterone through the skin.
Replaced once every 3 weeks followed by one week off.

Question 6

what is the implant?

Answer 6

it is a method of long acting reversible contraception (LARC).
it is a matchstick sized rod of plastic that is inserted into the upper arm and releases progesterone.
lasts over 3 years

Question 7

what is the injection?

Answer 7

an injection that releases the hormone progesterone, injection every 8,12,or 13 weeks.
however it cant be stopped and progesterone can make one depressed.
(LARC)

Question 8

what is the IUS (intrauterine system?

Answer 8

it is a small T shaped plastic device that contains the hormone progesterone.
The device needs to be fitted by a doctor or nurse
last 3-5 years

Question 9

what is the IUD (intrauterine device)

Answer 9

similar to the IUS but it does not release hormones, it releases copper.
lasts 5-10 years

Question 10

what does the typical combined pill contain?

Answer 10

30 ug oestrogen and 250ug levonorgestrel

Question 11

what does monophasic mean?

Answer 11

fixed amount of oestrogen and progesterone in each active tablet

Question 12

what does phasic (biphasic or triphasic) mean?

Answer 12

varying amounts of the two hormones according to the stage of the cycle

Question 13

what do typical combined pills contain?

Answer 13

30 ug ethinyloestradiol (oestrogen)
plus
250 ug levonorgestrel (progestogen)

e.g. Loestrin™, Microgynon™
Marvelon™, Cilest™

Question 14

how do combined oral contraceptives work?

Answer 14

inhibition of ovulation- lower levels of oestrogen in pill prevent the pituitary from releasing LH. With no LH present, eggs do not mature and ovulation does not occur.
effects on the endometrium
effects on the cervical mucus

Question 15

what is in the typical progesterone only pill?

Answer 15

500 ug ethynodiol (Femulen™)
or
350 ug norethisterone (Micronor™)

Question 16

how do progesterone only contraceptives work?

Answer 16

effects on the endometrium
effects on cervical mucus

Question 17

how does the copper IUD work?

Answer 17

copper works as a spermicide
creates local inflammatory reaction
preventing sperms to reach fertilised egg
might also prevent implantation ]however doesn’t effect ovulation

Question 18

can the copper IUD be used as emergency contraception?

Answer 18

yes, it is effective immediately after implantation. Fertilisation is inhibited through the effect of copper on the ovum.
if fertilisatoin has already occurred, then the endometrial inflammatory reaction has been shown to have an anti-implantation effect.

Question 19

how do oral EHC work?

Answer 19

delays/prevents ovulation and fertilisation by altering the tubal transport of sperm and/or ova AND discourages implantaion i.e. prevents pregnancy.

Question 20

what age can you give EHC to?

Answer 20

females>13 years

Question 21

what are the fraser guidlines?

Answer 21

undersatnding?
maturity?
risk of repeat incident?
physical and mental health wellbeing?
patients best interest?

Question 22

what points should you consider before you supply EHC?

Answer 22

Duration since unprotected sex (3– 5 days)
Is the client present in the pharmacy?
Is the client aged 13 or over (Fraser guidelines)?
Other medication (enzyme inducers)?
Any other medical conditions (pregnancy, EHC is not an abortifacient)
Nature of emergency- is it ‘Just in case?’

Question 23

points to consider after supply?

Answer 23

If vomiting occurs within 2 hours
-take another dose
Can impact on menstrual cycle
-period may be early, late or on time
Contraception
-for reminder of cycle
Condoms
-not just for preventing pregnancy (STI/STDs)
Chlamydia
-signpost to services for testing