Contraception

Question 1

outline the mechanisms of action of COCP and progestogenic forms of contraception

Answer 1

Question 2

types of COCP?

Answer 2

• monophasic
  
  • take pills for 21 days and then stop for 7 days where you have a withdrawal bleed
• phasic
  
  • same but with varying amounts of hormone
• everyday
  
  • take everyday but 7 sugar pills included

Question 3

S/E of COCP?

Answer 3

• headache
• breast tenderness
• changes to libido

Question 4

Risks?

Answer 4

• HT
• Thrombosis
• increased breast cancer risk

Question 5

Contraindications to COCP?

Answer 5

• age>35 and smoker
• uncontrolled HT
• history of thrombosis
• history of thrombosis in family
• history of stroke
• breast cancer
• migraine w aura

Question 6

when should u start COCP?

Answer 6

first day of menstrual period

Question 7

S/E of POP?

Answer 7

• spotting / amenorrhoea
• breast tenderness
• acne

Question 8

mechanism of copper coil?

Answer 8

reduces sperm motility and survival

Question 9

+ve and -ve of copper coil?

Answer 9

+ve

• can be started at any time during cycle and is effective immediately
• ve
• can cause menorrhagia & IMB
• potential of causing uterine perforation on insertion
• increased risk of ectopic pregnancy

Question 10

+ve and -ve of mirena coil?

Answer 10

+ve

• makes periods lighter / disappear altogether
• ve
• spotting/irregular bleeding
• may cause uterine perforation during insertion
• increased risk of ectopic pregnancy

Question 11

how does Depo-provera work?

Answer 11

3 monthly IM injections of a progestogen

Question 12

when should u start depoprovera?

Answer 12

on first day of menstrual period

Question 13

-ve of depoprovera?

Answer 13

takes 12 months for fertility to return

Question 14

S/E of depo provera?

Answer 14

• weight gain
• acne
• spotting /irregular bleeding

Question 15

risk of depoprovera?

Answer 15

may cause osteoporosis

Question 16

+ve and -ve of implant?

Answer 16

• +ve: can improve dysmenorrhoea & does not affect bone mineral density
• -ve: worsening of acne, change in menstrual cycle ie menorrhagia, reduced libido

Question 17

when should you start contraception post birth & what can you take?

Answer 17

• not until 3 weeks post childbirth
• POP safe to use in breastfeeding
• COCP not

Question 18

outline the types of emergency contraception there are

Answer 18

• levonorgestrel (levonelle- morning after)
  
  • taken up to 72h post sex
• ella one
  
  • up to 120hrs
• copper coil- most effective
  
  • up to 5 days after

Question 19

S/E of levonelle?

Answer 19

vomiting, can trigger / worsen depression