Contraception

Question 1

the most used methods of contraception in the uk

Answer 1

COCs , PoPs and barrier methods

Question 2

aims of contraception

Answer 2

prevents gametes from being released

prevents gametes from meeting a receptive endometrium

prevents implantation

prevents hormone release/action

Question 3

how are COCPs (combined oral contraceptive pills) used and administered

Answer 3

taken daily for 21 days, followed by a 7-day break(which is when the withdrawal bleed occurs.)
sometimes used continuously even after the 21 days to avoid menstruation

if reasonably confident that the woman is not pregnant, the first course can be started on any day of the cycle. if starting on day 6 or later of the cycle, additional precautions(barrier methods) are indicated. the pills should be taken at approximately the same time each day.

Question 4

mechanism of action of COCPs

Answer 4

suppresses OVULATION by inhibiting FSH and LH secretion through hormonal feedback on the HPG axis

it also thickens the cervical mucus to prevent sperm entry and alters the endometrium to prevent implantation

Question 5

some benefits of COCPs beyond it’s function ass a contraceptive

Answer 5

regulates menstrual cycles, reduces pain and improves acne when used correctly

Question 6

MoA of PoPs

Answer 6

thickens the cervical mucus to block sperm and also inhibits ovulation by suppresing LH secretion (not all formulations do the second one )

Question 7

how are PoPs used/adminstered

Answer 7

NHS advises taking POPs daily at the same time, with some allowing a 12-hour window for effectiveness and others allowing a 3hour window

some PoPs are regarded as missed pills if administration is delayed for 12 hours or more from the last pill(12hours from the time u should be taking it at)

Question 8

PoPs are usually suitable during breastfeeding and when oestrogen is not tolerated, true or flase

Answer 8

true

Question 9

MoA of the contraceptive patch, and how it is administered

Answer 9

the patch supresses ovulation, thickens cervical mucus, an alters the endometrium to prevent pregnancy

it is worn on the skin for seven days. it is replaced weekly for 3 weeks, then one patch-free week (4 wk cycle)

Question 10

advantages of using the contraceptive PATCHES instead of other formulations

Answer 10

convenient, DISCREET and as effective as oral contraceptives

NB; may cause skin irritations

Question 11

MoA of the contraceptive injection

Answer 11

supresses ovulation by inhibiting hormone secretion and thickens the cervical mucus to prevent fertilisation

has a high dose of progesterone(prevents preg. for weeks )

Question 12

how is the contraceptive injection used n

Answer 12

it is used every 8-13weeks.

suitable for women seeking discreet, low-maintenance contraception without OESTROGEN

Question 13

side effects of the contraceptive injection

Answer 13

menstrual changes and delayed fertility return

Question 14

describe the vaginal ring. what is it’s MoA

Answer 14

a flexible, hormone-releasing contraceptive device inserted vaginally for MONTHLY use

supresses ovulation, thickens cervical mucus and thins the endometrial lining to prevent pregnancy

may be contraindicated with OESTROGEN

Question 15

how does the contraceptive implant work

Answer 15

it’s a small flexible rod inserted under the upper arm to release progestogen, thereby inhibiting ovulation. this thickens the cervical mucus, and alters endometrial lining.
provides contraception long-term(up to 3 years)

Question 16

the benefits/advantages of the contraceptive implant

Answer 16

Over 99% effective up to 3 yrs, low maintenance, REVERSIBLE,
suitable for those avoiding estrogen methods

NB; it may however cause irregular bleeding / amenorrhea

Question 17

how does the female condom work

Answer 17

lines the vaginal canal and blocks sperm entry.

Question 18

Cervical cap MoA

Answer 18

Creates a deal over the cervical opening , preventing sperm migration into the uterus

NHS recommends using with spermicides before sex

It is smaller than a diaphragm

Question 19

MoA of the cervical diaphragm

Answer 19

Covers the cervix to block sperm entry, can be used w spermicide to enhance effectiveness

Inserted before sex Ann’s must remain for six hours after sex

Question 20

Types of IUDs (intrauterine devices )

Answer 20

Copper and hormonal

Question 21

Copper iuds moa

Answer 21

They are toxic to aprèm , thereby impairing motility and viability

Also indices a local inflammatory response in the endometrium , preventing inflammation

Question 22

Hormonal IUDs MoA

Answer 22

Releases levonorgestrel locally in the uterus , thickening the cervical mucus and inhibiting sperm penetration

Thins the endometrial lining too

NB: it may inhibit ovulation in some ppl

Question 23

Name some natural contraceptive methods

Answer 23

Fertility awareness methods (FAMS)

Withdrawal method (coitus interruptus)

Lactational amenorrhea method

Question 24

describe the MoA of FAMs(fertility awareness methods)

Answer 24

here, sexual intercourse is avoided during fertile days to prevent fertilization. it is recommended that we track the menstrual cycle, basal body temperatureand cervical mucus to identify the fertile window.

it relies on understanding hormonal changes (e.g FSH, LH, oestrogen and progesterone) than regulate ovulation

Question 25

describe the MoA of the withdrawal method of contraception

Answer 25

here the penis is withdrawn before ejaculation to prevent sperm entering the vagina. it does not alter the hormonal cycle, relies on behavioural control ## Footnote note that it is less effective due to pre-ejaculation

Question 26

the MoA of Lactational amenorrhea method(LAM) as contraception

Answer 26

uses breastfeeding to avoid ovulation, which stops the return of menstrual periods and prevents pregnancy very effective when done right. relies on 3 specific criteria; Baby must be under 6 months old Amenorrhea: a woman must have no return of her period(postpartum) the woman must fully be breastfeeding her baby, with no more than 4 hours btn daytime feeds/ 6hrs btn nightime feeds

Question 27

the sterilisation method(aka tubal ligation ) of contraception is permanent, true or false

Answer 27

true

Question 28

how does sterilisation as a mode of contraception work

Answer 28

it is a minor surgical procedure to cut or seal the vas deferens, preventing sperm from being included in ejaculate. it is usually done under local anaesthesia ## Footnote so it basically prevents sprm transport

Question 29

is sterilisation available under the ns services

Answer 29

yes it is

Question 30

sterilisation affects testosterone production or sexual function, true or false

Answer 30

false, it does not affect either

Question 31

when sterilised, are sperms still produced in the body

Answer 31

yes they are, but are reabsorbed by the body instead of being ejaculated during sex

Question 32

name some emergency contraceptives in the uk

Answer 32

Levonogestrel ( Levonelle®, Emerres®, Upostelle®) Ulipristral acetate (ellaOne®) Copper IUD ( T-Safe®, Flexi-T®, Nova-T®)

Question 33

MoA of levonogestrel

Answer 33

delays ovulation by inhibiting LH secretion, preventing follicular rupture it is LESS EFFECTIVE when closer to ovulation

Question 34

within what period of time should levonogestrel be taken after unprotected sex

Answer 34

72hours (3days)

Question 35

MoA of ulipristal acetate

Answer 35

it is a selective progesterone receptor modulator that primarily works by delaying or inhibiting ovulation. it suppresses LH surge and prevents follicular rupture it also delays ovulation by blocking progesterone

Question 36

MoA Copper IUD

Answer 36

uses copper to prevent fertilization, primarily by creating a spermicidal, inflammatory reaction in the uterus that is toxic to sperm and damages their motility and viability. it could prevent implantation too

Question 37

how are copper iuds administered

Answer 37

inserted within 5 days of unprotected sex

Question 38

side effects of copper iuds

Answer 38

cramping heavier periods risk of expulsion or perforation

Question 39

what are some common side effects of emergency contraceptives

Answer 39

nausea, vomitting, headache, menstrual changes

Question 40

arrange the emergency contraceptives from the most effective to the least effective

Answer 40

copper iud> ulipristal> levonorgestrel

Question 41

the effectiveness of hormonal emergency contraceptive pills are lower in women with higher body weight or BMI, particularly those containing levonogestrel, true or false

Answer 41

true

Question 42

are prescriptions required for emergency contraceptives in pharmacies

Answer 42

no, they can be accessed without, but consultation needs to be had with the pharmacist first ## Footnote can also get emergency contraceptives for free from ; sexual health clinics GP surgeries NHS walk-in centres Online pharmacies

Question 43

can men buy ellaone

Answer 43

yes no uk regulation prevents men from buying emergency contraception/morning afterpill