Self test

1

Which of the following statements about timing of ovulation is NOT true ?

  • 90% of women ovulate on day 14 of a 28 day cycle, making their fertile window day 9-14
  • Women with a regular cycle can ovulate any time from day 6-21
  • The timing of the fertile window can be highly unpredictable
  • Ovulation is unpredictable

Correct. This statement is untrue.

Incorrect. This statement is true. The untrue statement is ‘90% of women ovulate on day 14 of a 28 day cycle, making their fertile window day 9-14.’

2

Can ellaOne® delay follicular rupture even when given in the late follicular phase, at the time when ovulation is imminent?

  • it can still postpone ovulation for 5 days
  • Yes, for at least 10 days
  • Yes, for at least 7 days
  • No

Correct. ellaOne® can delay follicular rupture for at least 5 days.

Incorrect. ellaOne® can delay follicular rupture for at least 5 days.

3

Which of the following statements is NOT true?

  • ellaOne® is significantly more effective than levonorgestrel when taken 0-24 hours after UPSI
  • ellaOne® is significantly more effective than levonorgestrel when taken 0-72 hours after UPSI
  • ellaOne® should not be used beyond 72 hours after UPSI
  • ellaOne® can be taken up to 5 days after UPSI  

Correct. This statement is untrue. ellaOne® can be used up to 120 hours after UPSI.

Incorrect. This statement is true. The untrue statement is ‘ellaOne® should not be used beyond 72 hours after UPSI.’ In fact ellaOne® can be used up to 120 hours after UPSI.

4

Who must not take ellaOne®?

  • Women who are pregnant or are hypersensitive to the active substance or any of the excipients
  • Women who are younger than 20 or older than 40
  • Women who are on an oral contraceptive
  • All of the above

Correct. Women who are pregnant or are hypersensitive to the active substance or any of the excipients must not take ellaOne®.

Incorrect. Women who are pregnant or are hypersensitive to the active substance or any of the excipients must not take ellaOne.®

5

What advice would you give about sex after ellaOne®?

  • Do not have sex until your next period after taking ellaOne®
  • Explain that a barrier method of contraception must be used until the next period – even if the woman continues with her oral method of contraception
  • Explain that ellaOne® will protect the woman until her next period
  • Explain that a barrier method must be used for 5 days after taking ellaOne®

Correct. Explain that a barrier method of contraception must be used until the next period – even if the woman continues with her oral method of contraception.

Incorrect. The right advice is to explain that a barrier method of contraception must be used until the next period – even if the woman continues with her oral method of contraception.

6

What would you advise about return to fertility following ellaOne®?

  • Fertility will not return to normal
  • Fertility will return to normal eventually
  • A slow return to fertility is likely
  • A rapid return to fertility is likely, so contraception is important

Correct. A rapid return to fertility is likely, so contraception is important.

Incorrect. A rapid return to fertility is likely, so contraception is important.

7

What is the most important factor in EC provision ?

  • The speed of intake, ideally within 24 hours of UPSI
  • Providing the woman with adequate pharmacy counselling
  • Having a warm and non-judgmental approach
  • Making the experience as easy as possible

Correct. The most important factor is speed of access, ideally within 24 hours of UPSI

Incorrect. This answer is correct but the most important factor is speed of access, ideally within 24 hours of UPSI.

8

How would you reassure a woman who asks if EC is the same as abortion ?

  • Tell her that ellaOne® works by postponing ovulation (release of an egg). It is not abortive, and it cannot stop a pregnancy that has already started
  • Ask her to read the Patient Information Leaflet

Correct. Tell her that ellaOne® works by inhibiting or postponing ovulation (release of an egg). It is not abortive, and it cannot stop a pregnancy that has already started.  

Incorrect. Tell her that ellaOne® works by inhibiting or postponing ovulation (release of an egg). It is not abortive, and it cannot stop a pregnancy that has already started.

9

Is ellaOne® suitable for breastfeeding women ?

  • Yes, but they have to interrupt breastfeeding for 1 week. During this time it is recommended to express and discard the breast milk in order to stimulate lactation.
  • Yes, but they have to interrupt breastfeeding for 1 month.
  • Breastfeeding is not recommended for 3 days after ellaOne® intake
  • ellaOne® is not recommended in women who are breastfeeding

Correct. Breastfeeding is not recommended for one week after ellaOne®. During this time it is recommended to express and discard the breast milk in order to stimulate lactation.

Incorrect. Breastfeeding is not recommended for one week after ellaOne®. During this time it is recommended to express and discard the breast milk in order to stimulate lactation.

10

Which of the following drugs cannot be used concomitantly with ellaOne®?

  • CYP3A4 inducers
  • Long term use of Ritonavir
  • EC containing levonorgestrel
  • All of the above

Correct. All of the above cannot be used concomitantly with ellaOne®.

Incorrect. All of the above cannot be used concomitantly with ellaOne®.

11

What advice would you give to women about their next period after taking ellaOne®?

  • It is usually early
  • It is usually late
  • It can be earlier or later than expected by a few days, but if more than a week late you should do a pregnancy test.
  • It is fine if you miss your next period

Correct. It can be earlier or later than expected by a few days.

Incorrect. It can be earlier or later than expected by a few days.

12

How soon should you advise a woman to take ellaOne®?

  • As soon as she gets home
  • When she has her next meal
  • As soon as possible – even in the pharmacy
  • Before she goes to bed

Correct. As soon as possible – even in the pharmacy.

Incorrect. You shoud advise to take ellaOne® as soon as possible – even in the pharmacy.  

References

1. Wilcox AJ ym. BMJ 2000; 321: 1259–62.
2. Glasier AF ym. The Lancet 2010; 375: 555–562.
3. ellaOne®-valmisteyhteenveto.