Contraception – Your questions answered

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The questions answered in this podcast are listed below.
They were compiled by GPs and health professionals around Australia.

1. Exactly what is the point of quadriphasic/triphasic Pills?
2. Can you skip the hormone free pills with Slinda?
3. How long is it safe to continue extended use of an oral contraceptive pill? Can you just keep skipping until breakthrough bleeding occurs or is it better to have a withdrawal bleed every 3-4 months?
4. I was interested to hear the panel talk about cyproterone pills? What exactly is the VTE risk on these Pills and how long can a woman safely use them?
5. Can you expand a little more on the safety of using a combined oral contraceptive pill in a young woman with diabetes?
6. What’s the latest advice on the use of the COCP in women with migraines? I have a woman who has migraines without aura but is now over 40 and has recently started antihypertensive medications (now well controlled)
7. Is it safe to prescribe the combined contraceptive pill in a youngster aged only 12 years of age?
8. Why do we need to stop the combined OCP after age 50?
9. What features would alert a GP to the need for further investigation if a woman is still having regular periods beyond the age of 55?
10. Can we rely on a combined pill for contraception post gastric sleeve surgery? We were advised by the panel that it might be less effective- what is the evidence for this and what are the alternatives?



11. Can you please advise what to do if someone has been on the depo for 2yrs and would like to continue? If they are young, is it safe to continue and for how long? If they are approaching menopause is it better to stop as there would be less time for bone density to recover?



12. What is the correct figure for expulsion of IUDs? I’ve read figures in the literature of up to 20% but in my practice as a GP I think this sounds very high, as I’ve only come across one expulsion, in a woman with menorrhagia.
13. How long after Mirena insertion do we expect bleeding to continue? Is it normal to bleed for up to 6 weeks post Mirena insertion?
14. Are there specific additional microbiology tests we should request for other than M/C/S if a woman is having discharge or abnormal bleeding and has a Mirena or Kyleena IUD?
15. Is actinomyces still a thing? What treatment options are recommended? Does the IUD need to be removed?


Host: Dr Terri Foran, Sexual Health Physician
Guest: Dr Clare Boerma, General Practitioner
Total time: 32 mins

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Last Updated: 9 Feb, 2024

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Dr Clare Boerma


Dr Clare Boerma

General Practitioner; Medical Director, Family Planning NSW

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