Contraception

Question 1

5 methods of female contraception and how common they are

Answer 1

• Combined oral contraceptive pill (COC), 25%
• Progestogen-only pill (POP), 5%
• Progestogen-only implants or injectable, 3%
• Intrauterine methods (coil), 6%
• Sterilised, 28%

12% not using contraception despite sexual activity and no wish to become pregnant

Question 2

How effective are most methods of contraception

Answer 2

Over 99%, if used consistently and correctly

Question 3

What 2 hormones are in the Combined oral contraceptive pill (COC)

Answer 3

• Ethinyl oestradiaol (EE)

- Synthetic Progesterone (progestogen)

Question 4

How is the combined oral contraceptive pill (COC) taken

Answer 4

• Usually taken for 21 days with a pill free week

- Takes 7 days to “switch off” ovaries

Question 5

How does the combined oral contraceptive pill (COC) work

Answer 5

• Prevents ovulation
• Alters FSH and LH - no surge
• Prevents implantation by providing an inadequate endometrium
• Inhibits sperm penetration of the cervical mucus by altering quality and character of mucus (?more viscous?)

Question 6

Non-contraceptive benefits of COC

Answer 6

• Reduction in heavy menstruation and anaemia
• Reduction in functional ovarian cysts
• 50% reduction in ovarian and endometrial cancer

Question 7

How does Progestogen-only pill work

Answer 7

• Cervical mucus is rendered impenetrable by sperm
• Maximum effect ~48hrs after ingestion
• Effect lost if more that 3 hours late

Question 8

Options for emergency contraception

Answer 8

• CU-IUD most effective option use within 72hrs of unprotected sex (Levonorgestrel)
• Newer option of Ella one can be used up to 120hrs
• Less effective than ongoing contraception

Question 9

2 types of Abortions

Answer 9

• Medical (MTOP)

- Surgical (STOP)

Question 10

What is used in MTOP

Answer 10

• Mifepristone (“switches off” pregnancy hormone which prevents the uterus contracting
• 48hrs later prostaglandin initiates uterine contraction which opens the cervix and expels pregnancy