Contraception Initiation and Quick Start Methods

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Questions and Answers

Which contraceptive methods can be initiated on days 1-5 of the natural menstrual cycle without requiring extra precautions?

Combined Hormonal Contraceptives (CHC) and Progestogen-only Pill (POP) (correct)

Copper Intrauterine Device (Cu-IUD) only

Intrauterine System (IUS) and Progestogen-only pills

Only the Progestogen-only Injectable (DMPA)

What should a clinician do to ensure quick-starting contraception is safe for a patient?

Confirm a positive pregnancy test

Exclude the possibility of pregnancy (correct)

Require a waiting period of one menstrual cycle

Advise against quick-starting if there's a risk of early pregnancy

What is the recommendation for extra precautions when quick-starting Combined Hormonal Contraceptives?

Use extra precautions for 7 days (correct)

Use extra precautions for 3 days

No extra precautions are needed

Use extra precautions for 14 days

If a woman quickly starts using CHC after a recent unprotected sexual intercourse, what should be the follow-up action?

Take another high sensitivity urine pregnancy test after 21 days Signup and view all the answers

Which of the following statements is true regarding quick-starting POPs?

Extra precautions should be used for 2 days Signup and view all the answers

What is the role of emergency contraception following unprotected sexual intercourse?

It aims to prevent unwanted pregnancy and depends on the current contraceptive method Signup and view all the answers

Emergency contraception options include which two main decision-making pathways according to guidelines?

Copper IUD vs. Oral EC Signup and view all the answers

What is the best practice regarding clinician accreditation for initiating and quick-starting contraception?

Only those with NICE-approved accreditation should initiate and quick-start contraception Signup and view all the answers

What is the main mechanism of action of Ulipristal Acetate EC?

Delaying ovulation Signup and view all the answers

What is the maximum time frame in which Ulipristal Acetate can be taken effectively after unprotected sexual intercourse?

120 hours Signup and view all the answers

What should be avoided if a patient has used any progestogen in the 7 days prior to seeking emergency contraception?

Using Ulipristal Acetate Signup and view all the answers

What defines the Cu-IUD as the gold standard option for emergency contraception?

It poses a negligible risk of pregnancy after fitting. Signup and view all the answers

What is the intended result of using Levonorgestrel as an emergency contraception method?

Delay of ovulation before the LH surge Signup and view all the answers

Which statement is true regarding Ulipristal Acetate's effectiveness when progestogens are present?

Its ability to delay ovulation can be reduced by progestogens. Signup and view all the answers

Which of the following emergency contraceptive methods is not effective after 120 hours of UPSI?

Levonorgestrel Signup and view all the answers

Study Notes

Initiating Contraception

Combined hormonal contraceptives (CHC) and progestogen-only pills (POP) can be initiated on days 1-5 of the menstrual cycle and are immediately effective.
Progestogen-only injectables and the subdermal implant (SDI) can also be initiated on days 1-5 of the menstrual cycle without requiring extra precautions.
The intrauterine system (IUS) can be fitted on days 1-7 of the menstrual cycle without requiring extra precautions.

Quick Starting Contraception

Quick-starting contraception can decrease the risk of unplanned pregnancy.
All methods can be quick-started if it's reasonably certain the individual is not pregnant.
CHC, POP, depot medroxyprogesterone acetate (DMPA), and the SDI can be quick-started even with a risk of early pregnancy if a high sensitivity pregnancy test is negative.
There's no evidence that hormones are harmful to a developing fetus.
Extra precautions should be used for 7 days when quick-starting combined hormonal methods, the SDI, or the IUS.
Extra precautions should be used for 2 days for POPs

Emergency Contraception

Emergency contraception is used after unprotected sexual intercourse (UPSI) to prevent unwanted pregnancy.
The decision on the appropriate method depends on the contraception being used.
The Faculty of Sexual and Reproductive Healthcare (FSRH) provides guidelines for emergency contraception.

Emergency Contraception Choices

Emergency contraceptive methods include:
- Ulipristal acetate (UPA)
- Copper-bearing intrauterine device (Cu-IUD)
- Levonorgestrel (LNG)

Ulipristal acetate (UPA)

UPA is an oral pill with 30 mg of the selective progesterone receptor modulator.
UPA delays ovulation for at least 5 days until sperm are no longer viable.
It's effective up to 120 hours following UPSI.
Re-starting hormonal contraception should be delayed for 5 days after using UPA, and its use should be avoided within 7 days of using any progestogen.

Copper Intrauterine Device (Cu-IUD)

The Cu-IUD should be fitted within 120 hours of UPSI or within 5 days of the earliest possible ovulation.
It works by preventing fertilization and implantation.
The Cu-IUD is the gold standard option with a negligible risk of pregnancy after fitting.

Levonorgestrel (LNG)

LNG is an oral pill with 1500 µg of the progestogen levonorgestrel.
LNG delays ovulation if administered before the luteinizing hormone (LH) surge.
It's effective up to 72 hours after UPSI.

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Description

This quiz explores the recommended practices for initiating various contraceptive methods, including combined hormonal contraceptives and injectables. It covers the timelines for starting these methods and the importance of quick-starting options to reduce the risk of unplanned pregnancies. Test your knowledge on this essential aspect of reproductive health.