6.         Look at the illustration.

a)         What hormone is released by the above coil?

            Levonorgestrel.

b)         How long would it work for?

            5 years.

c)         Over a period of time, what is the most likely change to a woman’s period with this coil in situ?

            Decreased bleeding and PV spotting leading to amenorrhoea.

d)         You examine the woman for a smear 6 months post-insertion and the string cannot be seen on speculum examination. What immediate measures would you take?

            Probe around the endocervical canal for coiled string.

e)         If you find she is 8 weeks pregnant, what would you do with the coil if the string cannot be seen and she wants to keep the pregnancy?

            Continue with pregnancy and leave it in place.

f)          What is the relative risk of an ectopic pregnancy with this coil?

            Decreased risk.