Hormonal Contraception

Question 1

What is the Pearl Index?

Answer 1

The number of failures per 100 women using the method for 1 year.

Question 2

How does family planning separate sex and pregnancy?

Answer 2

It allows sexual activity without the consequence of pregnancy.

Question 3

What are the key benefits of birth control for maternal health?

Answer 3

Reduces maternal morbidity and mortality.

Question 4

What are the key benefits of birth control for child health?

Answer 4

Enhances child survival by spacing births and improving maternal care.

Question 5

Name six broad methods of contraception.

Answer 5

Traditional methods, barrier methods, pills, injections, implants, surgery.

Question 6

List five traditional contraceptive methods.

Answer 6

Polygamy, abstinence, safe periods, lactational amenorrhoea, coitus interruptus.

Question 7

What are the constituents of progesterone-only pills (POP)?

Answer 7

Only progesterone.

Question 8

What is the Pearl Index of POP?

Answer 8

1–3 per hundred woman-years (PHWY).

Question 9

What are the modes of action of POP?

Answer 9

Inhibits ovulation, thickens cervical mucus, causes endometrial changes.

Question 10

List three advantages of POP.

Answer 10

Reduces menstrual blood loss, dysmenorrhoea, and endometrial cancer risk.

Question 11

List three disadvantages of POP.

Answer 11

Irregular bleeding, strict dosing schedule, mood changes.

Question 12

In what situations is POP recommended?

Answer 12

During lactation, and when oestrogen is contraindicated.

Question 13

What are the constituents of combined oral contraceptives (COC)?

Answer 13

Ethinylestradiol or mestranol + a progestogen (e.g., levonorgestrel, desogestrel).

Question 14

What is the Pearl Index of COC?

Answer 14

0.1 PHWY.

Question 15

What are the mechanisms of action of COC?

Answer 15

Inhibits ovulation, thickens cervical mucus, alters endometrium.

Question 16

List three advantages of COC.

Answer 16

Regular, lighter, painless menses; other systemic benefits.

Question 17

List three disadvantages of COC.

Answer 17

Risk of VTE, MI, stroke, and drug interactions.

Question 18

What are the absolute contraindications of COC?

Answer 18

Pregnancy, suspected cancer, acute liver disease, MI/stroke, severe hypertension, VTE, focal migraine.

Question 19

What are the relative contraindications of COC?

Answer 19

Age >35, smoking, obesity, diabetes, sickle cell disease.

Question 20

What are the types of injectable contraceptives?

Answer 20

Progesterone-only (DMPA, Noristerat) and combined (Lunelle).

Question 21

What is the Pearl Index of injectables?

Answer 21

0.1–2 per hundred woman-years.

Question 22

List two advantages and two disadvantages of injectables.

Answer 22

Advantages: safe, effective during lactation; Disadvantages: irregular bleeding, delayed fertility return.

Question 23

What are the common contraceptive implants used?

Answer 23

Norplant I & II (levonorgestrel), Implanon (etonogestrel).

Question 24

What is the effectiveness of implants?

Answer 24

0–0.05%.

Question 25

How do implants prevent pregnancy?

Answer 25

Inhibits ovulation, alters cervical mucus and endometrium, disrupts luteal phase.

Question 26

List two advantages and two disadvantages of implants.

Answer 26

Advantages: long-acting, effective; Disadvantages: insertion/removal issues, irregular bleeding.

Question 27

Name four types of barrier methods.

Answer 27

Condoms (male/female), diaphragm, cervical cap, sponge, spermicides.

Question 28

What is the effectiveness of male condoms?

Answer 28

2–5 PHWY; effectiveness drops with typical use (~21%).

Question 29

What are the advantages of barrier methods?

Answer 29

Protect against STIs, non-hormonal.

Question 30

What are the disadvantages of barrier methods?

Answer 30

May interfere with sexual spontaneity.

Question 31

What are the types of female sterilisation procedures?

Answer 31

Minilaparotomy, laparoscopy, hysteroscopy, quinacrine sterilisation.

Question 32

What is the male sterilisation method called?

Answer 32

Vasectomy.

Question 33

Name three new developments in contraception.

Answer 33

Mifepristone pills, contraceptive patches, vaginal rings, new implants, vaccines.

Question 34

What is the purpose of anti-hCG and anti-GnRH vaccines?

Answer 34

To provide long-acting immune-based contraception.

Question 35

What are two non-contraceptive benefits of contraception?

Answer 35

Regulation of menses, reduced risk of certain cancers (e.g., endometrial).