Self-Assessment Questions (SAQs) for Study Session 5

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering these questions. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module

SAQ 5.1 (tests Learning Outcome 5.2)

There are a lot of misconceptions about the use of oral contraceptives. List all the myths and rumours common in your community, and describe what you will do to overcome such problems.


There are a lot of misconceptions about the use of oral contraceptives. Some of those listed in Section 5.1 may also be common myths in your locality. In addition, the following misconceptions are sometimes cited:

  1. Some societies believe that oral pills cause severe heartburn if not taken with milk, so those who are not able to get milk should not take the pill.
  2. Some still perceive taking a pill is not allowed by God.
  3. Others say pills cause obesity and sometimes interfere with menstruation.

None of these are true.

SAQ 5.2 (tests Learning Outcome 5.3)

Explain how oral contraceptives work.


The pill works by altering the body’s reproductive hormone balance. As a result, the following occurs:

  1. The woman does not release an egg (ovum) each month from one of her ovaries, so ovulation cannot take place.
  2. The cervical mucus becomes thickened and forms a ‘mucus plug’ which makes it difficult for sperm to get through to the uterus (womb) to fertilise an egg.
  3. The lining of the uterus gets thinner and thinner. This makes it unlikely that a fertilised egg will be able to attach to the uterus.

SAQ 5.3 (tests Learning Outcome 5.4)

A woman who has forgotten to take three COC pills in the second week of her last menstrual period comes to your health post for help. What would you advise?


If a woman who forgot to take three COC pills in the second week of her last menstrual period comes to your health post, you may tell her she should take the following actions.

  1. Take a pill as soon as possible.
  2. Take the next pill at the usual time. This may mean taking two pills on the same day, or even at the same time.
  3. Continue taking active pills (see Figure 5.1) as usual, one each day.

SAQ 5.4 (tests Learning Outcomes 5.1 and 5.4)

Suppose one of your clients who is using COCs complains of a severe headache, vomiting and blurred vision. She is worried about becoming pregnant if she stops taking her pills. What would you tell her to help her?


Firstly, you should check her blood pressure to see if it has increased. In any case, these symptoms are serious and require medical intervention. So, you need to tell her to seek medical advice at the hospital or health post.

SAQ 5.5 (tests Learning Outcomes 5.4)

What is the major difference between COCs and mini-pills? Who would be eligible to use the mini-pill?


The major difference between COCs and mini-pills is that there are two hormones in COCs (progesterone and oestrogen), while mini-pills contain only one hormone (progesterone). All women are eligible to take mini-pills, but they are most suitable for breastfeeding mothers, as they do not interfere with breastmilk.

SAQ 5.6 (tests Learning Outcome 5.5)

Compare the main advantages and disadvantages of COCs and mini-pills.

Organise your comparison into a table.


The table below summarises the main advantage and disadvantages of COCs compared to mini-pills.

  • Very effective and safe.
  • Can be used at any age.
  • Women’s fertility returns quickly after pills stop.
  • Can prevent or decrease iron deficiency anaemia.
  • Decrease menstrual cramps and pain.
  • Reduce the risks of ectopic pregnancies, endometrial cancer, ovarian cancer, ovarian cysts, pelvic inflammatory disease, benign breast disease.
  • Can be used as an emergency contraceptive after unprotected sex.
  • Can be used by nursing mothers, because the quantity and quality of breastmilk is not affected.
  • Do not cause oestrogen-related side-effects, such as heart attacks or strokes.
  • Easier to understand how to take them, since you take one pill every day with no break.
  • May help prevent benign breast disease, endometrial and ovarian cancer, and pelvic inflammatory disease.
  • Can slightly reduce milk production.
  • Very rarely can cause strokes, blood clots in deep veins of the legs, heart attacks.
  • They can’t prevent STIs, like HIV/ AIDS.
  • For women who are not breastfeeding, changes in menstrual bleeding, including irregular periods, spotting or bleeding between periods, and amenorrhoea (missed periods).
  • Prolonged or heavy menstrual bleeding in a few women.
  • Progestin-only oral contraceptives may lengthen amenorrhoea during breastfeeding.
  • For women who are not breastfeeding, even taking a pill more than a few hours late increases the risk of pregnancy.
  • They can’t prevent STIs, like HIV/ AIDS.

SAQ 5.7 (tests Learning Outcome 5.6)

A client using COCs develops pulmonary tuberculosis. What do you think would be important to tell her with regard to her contraception?


If one of your clients who is using COCs has developed pulmonary tuberculosis and been put on anti-tuberculosis drugs, you should advise her to switch her contraceptive method from COCs to a mechanical method, such as condoms or IUCD, so that she will avoid any drug interactions or possible side-effects.

Summary of Study Session 5