Self-Assessment Questions

25. Contraception

• Describe the mechanism of action of combination oral contraceptive pills (OCPs), their risks and major contraindications.

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  Correct answer:
  Combination OCPs prevent pregnancy by multiple mechanisms, including thickening of cervical mucus to prevent sperm transport and alteration of the uterine lining to block implantation. Combination OCPs can also inhibit ovulation, although that effect is more inconsistent as lower dose products are brought to market. Risks include an increase in thromboembolic disease, nonthrombotic stroke and gallbladder disease. The largest population of potential users for which combination OCPs are contraindicated is smokers over 35 years of age.