contraception

Question 1

what are the types of contraception

Answer 1

• combined hormonal contraception
• progestogen only method
• intrauterine contraception
• emergence contraception
• sterilisation

Question 2

what is the pearl index

Answer 2

number of pregnancies per 100 women per years of exposure

Question 3

what is life table analysis

Answer 3

pregnancy rate over a specified time frame

Question 4

what is the benefit of long active reversible contraception (LARC)

Answer 4

less user input so minimises user failure rates

Question 5

what are the types of combined hormonal contraception

Answer 5

• pill (daily)
• patch (changed weekly)
• vaginal ring (changed every 3 weeks)

Question 6

what does combined hormonal contraception consist of

Answer 6

ethinyl estradiol & synthetic progestogen

Question 7

what are the benefits of combined hormonal contraception

Answer 7

• stops ovulation (helps with PMS)
• reduces bleeding
• reduction in ovarian cysts
• improves acne/hirsutism
• reduction in benign breast disease, rheumatoid arthritis, colon cancer and osteoporosis

Question 8

what are side effects of combined hormonal contraception

Answer 8

• breast tenderness
• nausea
• headache
• irregular bleeding for first 3 months
• venous thrombosis (DVT, PE)
• arterial thrombosis (MI, ischaemic stroke)
• cervical/breast cancer

Question 9

what are precautions of combined hormonal contraception

Answer 9

avoid if active gall bladder disease or previous liver tumour

Question 10

what are the types of progestogen only methods

Answer 10

• pill (desogestrel)
• jag
• implant

Question 11

what are the benefits of progestogen only methods

Answer 11

• oestrogen free so few contraindications
• all cycles anovulant
• alters cervical mucus

Question 12

what are the side effects of progestogen only methods

Answer 12

• headache
• hair loss/gain
• acne
• apetite increase
• bloating/fluid retention
• mood change

Question 13

what are the types of intrauterine contraceptions

Answer 13

• the coil
• copper IUD (hormone free; lasts 5-10 years)
• levenorgestrel IUS (slow release progestogen - mirena, kyleena)

Question 14

what are the types of emergency contraception

Answer 14

• copper IUD (within 120 hours UPSI or by day 19)
• levonorgestrel pill (within 72 hours)
• ulipristal pill (within 120 hours; contraindications with breastfeeding/enzyme inducing drugs)

Question 15

when to start contraception

Answer 15

start in first 5 days of cycle for immediate cover

Question 16

when can you get pregnant

Answer 16

21 days after delivery

5 days after miscarriage/abortion

Question 17

how long is breastfeeding contraceptive for

Answer 17

first 6 months + feeding every 4 hours + amenorrhoeic

Question 18

what are some enzyme inducing drugs

Answer 18

carbamazepine
topiramate
rifampicin
st john’s wort

Question 19

what do enzyme inducing drugs do

Answer 19

increase metabolism of progestogen and oestrogen

reduce effectiveness of combined pill, patch and ring, POP and implant

progestogen injections, copper IUD or levonorgestrel IUS not affected

Question 20

what are methods for female sterilisation

Answer 20

laparoscopic sterilisation - fishie clips applied across tube to block lumen