20: Contraception Flashcards
Efficacy of LARCs compared to sterilisation
Implants, mirena IUS and vasectomy have better efficacy than tubal sterilisation
Ligation - risks a/w operation including infection, bleeding, damage to surrounding structures
Mechanism of CuIUD (LARC)
Toxic to sperm and prevention of fertilisation
Advantages/disadvantages CuIUD
Disadvantages: heavier, more painful periods + more likely to be ectopic if pregnant.
Risks of: expulsion, lost threads, perforation, PID
Advantages: long acting, fully funded
Mechanism of Mirena
- Thin endometrium
- Thicken cervical mucus
- Prevent ovulation (in some)
Contraindications for Mirena
- Personal hx breast cancer, pregnancy, active chlamydia infection, undiagnosed bleeding/malignancy, distortion of uterine cavity
Main mechanism of Jadelle
Inhibits ovulation and thickens cervical mucus
Absolute contraindications to jadelle
Pregnancy, current breast cancer, undiagnosed PV bleeding, sensitivity to LNG, liver tumour
Benefits of Jadelle
Long lasting, very effective, few contraindications, less ovulation pain/dysmenorrhoea, no effect on breast milk and return to fertility
How can heavy bleeding be alleviated when on Jadelle?
3/12 trial of COC unless contraindicated (can try POP if so)
What is the leeway with DMPA?
4 weeks
Side effects of DMPA
Weight gain, irregular bleeding, delay in fertility
Benefit of DMPA
Not affected by enzyme inducers, women with epilepsy have greater seizure control
Mechanism of cezarette
Inhibit ovulation
Mechanism of low dose POP
Thickens cervical mucus
Disadvantages of noriday
Irregular bleeding
Short time window (3 hours) need 2/7 emergency contraception if you forget
