A 37-year-old multiparous woman has attended the GP practice to discuss contraceptive options. She has used combined oral contraceptives in the past but since having her last child has decided that she wants a more reliable option

c. This lady is a great candidate for an intra-uterine contraceptive device. There are two options either hormonally based devices or a copper device. These are rarely used in nulliparous ladies. The hormonal device is impregnated with progesterone and works in a similar way to the progesterone-only pills. The copper device is well known to have side-effects of heavy bleeding, but can be used as emergency contraception up to 5 days after unprotected sexual intercourse or up to 5 days prior to the next predicted ovulation.