1. What is the modern Pill’s approximate failure rate, given perfect compliance?
- a) roughly 0.1%
- b) roughly 0.5%
- c) roughly 1%
- d) roughly 5%
2. The Pill tends to:
- a) increase acne and hirsutism
- b) decrease acne and hirsutism
- c) have no effect on acne or hirsutism
3. Evidence exists that links starting the Pill in adolescence to:
- a) decreased final adult height
- b) higher risk of cancer in later life
- c) future fertility problems
- d) none of the above
- e) all of the above
4. Patients who suffer side effects such as bloating, headache or breakthrough bleeding soon after starting the Pill should switch to a different formulation.
- a) true
- b) false
5. Women should wait three months after stopping the Pill before trying to conceive.
- a) true
- b) false
6. According to SOGC guidelines, how many active pills may a woman safely miss without needing backup contraception?
- a) none
- b) 1
- c) 2
- d) 3
- e) up to a week’s worth
1. a) 0.1%. But without perfect compliance, failure rates range from 2-9%
2. b) Several OC pills are licensed in Canada for the treatment of acne and almost any OC will reduce symptoms of acne and hirsutism
3. d) There is no evidence to suggest that the Pill harms adolescents
4. b) False. These symptoms usually resolve within three months
5. b) False. This outdated guidance was based on fears that recent Pill use increased miscarriage risk, but research showed that those concerns were groundless
6. c) 2 pills. For more detailed guidance on missed pills, see http://www.parkhurstexchange.com/node/5310 The Pill comes of age
We'll send you $100 if we print your diagnostic challenge. Send case description (app. 450 words) with final diagnosis and outcome to: parkex@parkpub.com.
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