contraception basics

Question 1

main contraceptive methods

Answer 1

Natural family planning (“rhythm method”)
Barrier methods (i.e. condoms)
Combined contraceptive pills
Progestogen-only pills
Coils (i.e. copper coil or Mirena)
Progestogen injection
Progestogen implant
Surgery (i.e. sterilisation or vasectomy)

Question 2

4 levels of risk of starting contraception according to FSRH UKMEC guideline (2016)

Answer 2

UKMEC 1: No restriction in use (minimal risk)
UKMEC 2: Benefits generally outweigh the risks
UKMEC 3: Risks generally outweigh the benefits
UKMEC 4: Unacceptable risk (typically this means the method is contraindicated)

Question 3

what contraception for breast cancer px

Answer 3

avoid any hormonal contraception and go for the copper coil or barrier methods

Question 4

what contraception for Cervical or endometrial cancer px

Answer 4

avoid the intrauterine system (i.e. Mirena coil)

Question 5

what to avoid in px w wilsons disease

Answer 5

avoid the copper coil

Question 6

when should u avoiD COCP

Answer 6

Uncontrolled hypertension (particularly ≥160 / ≥100)
Migraine with aura
History of VTE
Aged over 35 smoking more than 15 cigarettes per day
Major surgery with prolonged immobility
Vascular disease or stroke
Ischaemic heart disease, cardiomyopathy or atrial fibrillation
Liver cirrhosis and liver tumours
Systemic lupus erythematosus and antiphospholipid syndrome

Question 7

how long is contraception required for in post menopausal women

Answer 7

contraception is required for 2 years in women under 50 and 1 year in women over 50 (after last period)

Question 8

what age can u have cocp till

Answer 8

50- it can treat perimenopausal sx

Question 9

what has risk of osteporosis

Answer 9

The progestogen injection (i.e. Depo-Provera)_ over 50y

Question 10

how long should ammenorhaic women take POP

Answer 10

until either:

FSH blood test results are above 30 IU/L on two tests taken six weeks apart (continue contraception for 1 more year)
OR
55 years of age

Question 11

choice of conbtraception under 20y

Answer 11

The progestogen-only implant is a good choice of long-acting reversible contraception (UK MEC 1)

The progestogen-only injection is UK MEC 2 due to concerns about reduced bone mineral density

Coils are UKMEC 2, as they may have a higher rate of expulsion

Question 12

when does feritlity return post biorth

Answer 12

21d

Question 13

best contraception for breastfeeding women

Answer 13

Lactational amenorrhea

POP

progesterone only implant

Question 14

when can u have copper coil or iUS insterted post birth

Answer 14

within 48hr or after 4 weeks

not in between

Question 15

when to restart cocp after birth

Answer 15

should not be started before 6 weeks after childbirth in women that are breastfeeding. The progestogen-only pill or implant can be started any time after birth.

Question 16

which contraception protects agaisnt sti

Answer 16

only condom

Question 17

how effective are condoms

Answer 17

98% with perfect use

82% with poor use

Question 18

other barrier methods for vaginal sex

Answer 18

Diaphragms and cervical caps

Question 19

barrier method for oral sex

Answer 19

dental dam