COCP

Question 1

How effective is COCP

Answer 1

more than 99% effective with perfect use, but less effective with typical use (91%)

Question 2

3 ways COCP prevents pregnancy

Answer 2

Preventing ovulation (this is the primary mechanism of action)

Progesterone thickens the cervical mucus

Progesterone inhibits proliferation of the endometrium, reducing the chance of successful implantation

Question 3

2 types of COCP

Answer 3

Monophasic pills contain the same amount of hormone in each pill

Multiphasic pills contain varying amounts of hormone to match the normal cyclical hormonal changes more closely

Question 4

First line COCP

Answer 4

a pill with levonorgestrel or norethisterone first line
(e.g. Microgynon or Leostrin).

These choices have a lower risk of venous thromboembolism.

Question 5

first line COCP for pre menstryual syndrome

Answer 5

anything containing drospirenone eg yasmin

Question 6

3 regimes to take COCP

Answer 6

21 days on and 7 days off

63 days on (three packs) and 7 days off (“tricycling“)

Continuous use without a pill-free period

Question 7

SE of COCP

Answer 7

Unscheduled bleeding is common in the first three months and should then settle with time
Breast pain and tenderness
Mood changes and depression
Headaches
Hypertension
Venous thromboembolism (the risk is much lower for the pill than pregnancy)
Small increased risk of breast and cervical cancer, returning to normal ten years after stopping
Small increased risk of myocardial infarction and stroke

Question 8

Best time to start COCP

Answer 8

first day of cycle ie first day of period

no additional conytraception required if started in first 5 days

Question 9

what to do if u start COCP after day 5 of cycle

Answer 9

requires extra contraception (i.e. condoms) for the first 7 days of consistent pill use before they are protected from pregnancy

Question 10

what to do when switching between COCPs

Answer 10

When switching between COCPs, finish one pack, then immediately start the new pill pack without the pill-free period.

Question 11

what to do when switching from POP to COCP

Answer 11

can switch at any time but 7 days of extra contraception (i.e. condoms) is required.

Question 12

What to do if u miss one dose of COCP

Answer 12

Take the missed pill as soon as possible (even if this means taking two pills on the same day)
No extra protection is required provided other pills before and after are taken correctly

Question 13

What to do if u miss 2 pills of COCP IF DAYS 1-7

Answer 13

Take the most recent missed pill as soon as possible (even if this means taking two pills on the same day)

Additional contraception (i.e. condoms) is needed until they have taken the pill regularly for 7 days straight

If day 1 – 7 of the packet they need emergency contraception if they have had unprotected sex

Question 14

What to do if u miss 2 pills of COCP IF DAYS 8-14

Answer 14

no emergency contraception is required

Question 15

What to do if u miss 2 pills of COCP IF DAYS 15-28

Answer 15

no emergency contraception is needed. They should go back-to-back with their next pack of pills and skip the pill-free period.

Question 16

when should u stop COCP if ur having major surgery

Answer 16

4 weeks before