A 23-year-old woman schedules a routine appointment. She has begun a sexual relationship and wants to start long term contraception as she and her partner do not plan on having children anytime soon. Her mother was diagnosed with breast cancer a decade ago, and the patient, along with her family, underwent testing at the time. She was found to have a BRCA1 mutation. Based on FSRH guidelines, what is the safest contraception method available?
A 32-year-old woman visits her GP clinic for contraception advice. She is a smoker, consuming 20 cigarettes daily, and has a BMI of 25 kg/m². She has no history of venous thromboembolism in her family or personal medical history. She underwent a right-sided salpingectomy for an ectopic pregnancy six years ago. Which of the following contraceptive methods would be unsuitable for this patient?
A young woman in her early twenties visits your GP clinic. She plans to start trying for a baby in a year’s time but wants to avoid pregnancy until then as she has important exams to take. She hopes to conceive soon after completing her exams. Which contraceptive method is known to cause a longer delay in the return to fertility?
A 36-year-old woman with a history of chronic pelvic pain has been diagnosed with endometriosis. Which of the following is not a recognized treatment for this condition?
A 25 year old woman visits the family planning clinic seeking advice on contraception. She has a history of epilepsy and is currently on carbamazepine medication. Additionally, her BMI is 39 kg/m² and she has no other medical history. What would be the most appropriate contraceptive option to suggest for her?
A 14-year-old girl comes to your GP clinic seeking contraception. She has been in a relationship with her 15-year-old boyfriend for 10 months. What is the best initial step to take?
Sarah is a 33-year-old woman who presents with severe pelvic pain that is unresponsive to paracetamol. The pain started four months ago and occurs four days before the onset of her menstrual cycle. The pain worsens as her period approaches and gradually improves once it ends. She also reports changing her menstrual pads every four hours.
Sarah began menstruating at the age of 14 and has had fairly regular cycles. In the past, she only experienced mild pain that was relieved with paracetamol, and her periods were not heavy. She is sexually active but uses condoms during intercourse.
During pelvic examination, no abnormalities were observed on speculum examination, and her abdomen examination was unremarkable.
What is the most appropriate next step in Sarah’s management?
A 43-year-old woman presents to the clinic to discuss contraception. She has not had a period for 10 months. Her blood pressure reading in clinic is 120/76 mmHg and she smokes 10 cigarettes per day. She has a history of successfully treated breast cancer 3 years ago. Which contraceptive method would you recommend?
As this woman has not had a period for 10 months, she may be entering the perimenopausal period. However, as she is under the age of 50, she still requires contraception. Based on her past history of breast cancer, hormonal methods of contraception are not recommended due to the potential risks. Therefore, a copper intrauterine device (Cu-IUD) would be the best option for her. According to the UK Medical Eligibility Criteria for Contraceptive Use, the Cu-IUD is a UKMEC Category 1 for women with a history of breast cancer. It is important to discuss the risks and benefits of each contraceptive method with the patient before making a final decision.
Sarah is a 26-year-old trans female who wants to discuss contraception options with you. She is in a committed relationship with another woman and they have regular unprotected intercourse. Sarah has no medical history and is currently undergoing gender reassignment using oestrogen and antiandrogen therapy, but has not had any surgical interventions yet. What would be the most suitable form of contraception to recommend for Sarah?
A 52-year-old woman comes to the postmenopausal bleeding clinic complaining of continuous vaginal bleeding for the past 2 weeks. What would be your initial investigation in the clinic?