Week 16

• What hormones do combined oral contraceptives (COCs) typically contain?

  Oestrogen and progestogen
• What is the usual form of oestrogen found in COCs?

  Ethinylestradiol
• Name one type of progestogen found in COCs.

  Levonorgestrel
• What factors influence how to start taking COCs?

  • Current method of contraception
  • Amenorrhoeic status
  • Post-partum and breastfeeding status
  • Recent miscarriage or termination
  • Use of emergency contraception
  • Switching from other contraceptive methods

  
• What does FSRH CEU Guidance address regarding COCs?

  Recommended actions after incorrect use of combined hormonal contraception
• How should vomiting and diarrhea be managed for COC administration?

  • If vomiting within 3 hours, take another pill.
  • If vomiting persists for 24 hours, follow missed pill rules.Use a barrier method during illness and for 7 days after.If illness occurs during last 7 pills, skip the pill-free phase.
• What should be done if vomiting occurs within the first 4 days of taking Qalira?

  Take another pill as soon as possible
• What is the protocol for Zoley if vomiting occurs after 24 hours?

  Follow the missed pill rules
• What drug interactions should be considered for COCs?

  • Lamotrigine
  • Griseofulvin
  • Herbal products
• What should be done if a patient has an upcoming surgery while on COCs?

  • Stop COC 4 weeks before major surgery.
  • Provide an alternative contraceptive method.
  • Restart COC after surgery if fully mobile.
• What is the maximum age for using COCs?

  Up to 50 years old
• What should be done after 50 years old regarding contraception?

  Switch to progestogen-only pill (POP) or copper intrauterine device (cu-IUD)
• How often should a review be conducted for COC users?

  • Every 3 months
  • Check blood pressure
  • Ensure proper technique for measuring blood pressure
• What should be done if blood pressure readings are normal during a consultation?

  Promote healthy behaviors
• What action should be taken for high blood pressure readings?

  Offer Ambulatory Blood Pressure Monitoring (ABPM)
• What should be done for very high blood pressure readings?

  Urgently refer the patient to their GP within 24 hours
• What should be done for low blood pressure readings?

  Provide appropriate advice and may refer to GP
• What are the steps to start using a combined patch?

  1. Exclude pregnancy
  2. Check current contraception
  3. Assess for emergency contraception
  4. Determine if switching contraceptives
  5. Check amenorrhoeic status
  6. Assess breastfeeding status
  7. Check postpartum status
  8. Inquire about recent miscarriage

  
• What should be done if the patch becomes detached?

  Ask how long it has been detached and when it came loose
• How should a patch be applied?

  • Place on clean, dry, hairless skin.
  • Use a different site each time.
  • Apply at the same time each day for three weeks.
  • Follow with a one-week free interval.
• What should be done if vomiting or diarrhea occurs while using the patch?

  
  

  .

  1. will no effect bioavailability and no additional protection needed.
• How should the vaginal ring be used?

  • Insert by compressing into the vagina for three weeks.
  • Follow with a seven-day free interval.
  • Check for the presence of the ring regularly.
  • Can remove for 3 hours if uncomfortable.
• What should be done if the vaginal ring is removed or broken?

  Ask how long it has been since it was removed or broken
• What are the adverse effects of the vaginal ring compared to COCs?

  • Higher risk of VTE than COCs
  • Vaginal irritation and discharge
  • Less nausea and irritability than COCs
• What are the pros and cons of using the vaginal ring?

  Pros:

  • Convenience
  • Not less effective if vomiting or diarrhea occurs
  • Same efficacy as patch and pill

  
  

  Cons:

  • Headaches, discharge, and infections
  • Discomfort during intercourse
  • Risk of breakage or expulsion
• What should be done if the ring has been out for more than 3 hours?

  • Reinsert it after washing with cold water.
  • If unprotected sexual intercourse (UPSI) occurred, use additional protection.
  • If more than 3 hours in the 3rd week, follow specific guidelines.
• What is the operation to sterilize a man called?

  Vasectomy
• What is the operation to sterilize a woman called?

  Tubal occlusion
• What are fertility awareness methods (FAM)?

  • Involves identifying fertile and non-fertile periods.
  • Monitoring fertility indicators like basal body temperature and cervical secretions.
• What conditions must be met for lactational amenorrhea method (LAM) to be effective?

  • Complete amenorrhea
  • Fully or nearly fully breastfeeding
  • Less than 6 months postpartum
• What are the advantages of using condoms?

  • Provide a barrier method to prevent pregnancy.
  • Reduce the risk of STIs.
  • Easy to obtain and use.
  • no drug interaction
  • only used during sexual activity
  • easy to obtain
• What are the disadvantages of using condoms?

  • Less effective than hormonal methods.
  • Requires careful disposal.
  • Potential for breakage or slipping. Male
  • loss of sensitivity.male
  • can bget pushed ,slip
• What should be done if a condom fails?

  • Seek advice for emergency contraception or STI testing.
  • Check for proper application and safety markings.
• What is the importance of checking the fit of diaphragms and caps?

  • Ensures effectiveness and comfort.
  • Requires reassessment after significant weight changes or childbirth.
• What should be done if a diaphragm or cap fails?

  • Seek advice for emergency contraception or STI testing.
  • Check for holes or deterioration.
• What is the link between HPV and cervical cancer?

  • HPV infection is a significant risk factor for cervical cancer.
• What is the recommended duration of use for various contraceptive methods?

  • Varies by method; consult guidelines for specifics.
• What is the role of community pharmacies in contraceptive supply?

  • Initiation and ongoing supply of oral contraception via Patient Group Directions (PGD).