COCP: Comorbidities

Question 1

What are the UKMEC recommendations for the COCP and smoking?

Answer 1

• UKMEC 2: age < 35 years
• UKMEC 3: age > 35 years and smoking < 15 cigarettes/day
• UKMEC 4: age > 35 years and smoking > 15 cigarettes/day

Question 2

What are the UKMEC recommendations for the POP and smoking?

Answer 2

There is no increased risk of CVD with the POP and therefore they are classed as UKMEC 1 with regards to smoking.

Question 3

What are the UKMEC recommendations for the COCP and Obesity?

Answer 3

• UKMEC 2: BMI 30-34 kg/m²
• UKMEC 3: BMI >= 35 kg/m²
• UKMEC 4: BMI >= 40kg/m²

Obesity increases the risk of VTE

Question 4

What UKMEC are all other contraceptives with regards to smoking?

Answer 4

UKMEC of 1.

Question 5

What are the UKMEC recommendations for the COCP and Migraine?

Answer 5

• UKMEC 3: Migraine without aura (Generally speaking)
• UKMEC 4: Migraine with aura

Question 6

What UKMEC are other contraceptives with regards to migraines?

Answer 6

Progestogen only methods such as the progestogen-only pill (POP), implant and injection are UKMEC 2 and are hence better choices.

Question 7

What factors need to be considered when prescribing the COCP in epilepsy?

Answer 7

• The effect of the contraceptive on the effectiveness of the anti-epileptic medication
• The effect of the anti-epileptic on the effectiveness of the contraceptive
• The potential teratogenic effects of the anti-epileptic if the woman becomes pregnant

Question 8

If you are using contraception whislt taking anti-epileptics, what does the FSRH also recommend you do?

Answer 8

Use condoms

Question 9

Most AEDs are UKMEC 3 for COCP and POP.

Which contraceptives are UKMEC 1?

Answer 9

Depo-Provera, IUD & IUS.