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Obs and Gynae Y4 > 7. Contraception > Flashcards

7. Contraception Flashcards

1
Q

Long-Acting Reversible Contraception

A
  • Intrauterine System (IUS or Mirena – or new SKYLA)
  • Intrauterine Device (IUCD or copper coil)
  • Contraceptive Injection (“depot” or medroxyprogesterone acetate)
  • Subdermal Contraceptive Implant (etonogestrel)
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2
Q

COCP Risks

A

VTE, breast cancer, cervical cancer

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3
Q

COCP role

A

Inhibits ovulation, inhibits implantation, thickens mucus

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4
Q

COCP ingredients

A

Ethinylestradiol and semi-synthetic progesterone

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5
Q

COCP Pros

A
  • Does not interrupt sex
  • Periods lighter, less painful
  • Helps PMS, reduced acne
  • Reduces risk of bowel and ovarian cancer
  • Protects from fibroids, ovarian cysts, fibrocystic breast disease
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6
Q

COCP Cons

A
  • Efficacy is user dependent

- Does not prevent STI

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7
Q

Emergency contraception

A

Levonelle, IUD, Ella One

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8
Q

Levonelle as emergency contraception

A

Single dose 1500 mcg, up to 72h post sex

Can be used >1x in a cycle, re-start contraception within 12h

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9
Q

IUD as emergency contraception

A

Banded IUD 380mm copper

Inserted up to 5 days post sex or 5 days post ovulation

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10
Q

EllaOne as emergency contraception

A

30 mg Ulipristal acetate; up to 120h

Can be used >1x in a cycle, re-start contraception after 5 days

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11
Q

EllaOne Emergency vs Progesterone contraception

A

EllaOne blocks action of progesterone (use extra precautions 7-21days)

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12
Q

Emergency contraception considerations

A

Abx prophylaxis, STI screen,

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13
Q

Intrauterine System

A

52 mg levonorgestrel, average 20 mcg/day.

Can be used for 5 years;

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14
Q

IUS risks

A

ectopic pregnancy, ovarian cysts, glucose tolerance affected,

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15
Q

IUS side effects

A

depression, reduced libido, headache, acne, irregular vaginal bleeding, vaginal discharge.

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16
Q

IUS role

A

inhibits implantation, thickens mucus

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17
Q

IUS Pros

A
  • No user dependent
  • Periods lighter, less painful, no periods
  • long lasting and reversible
  • does not interfere with sex
18
Q

IUS Cons

A
  • Discomfort and risk of insertion

- Irregular vaginal bleeding

19
Q

IUD

A

Licensed for 5-10 years

20
Q

IUD role

A

Inhibits fertilisation and implantation

21
Q

IUD risks

A

Ectopic pregnancy

22
Q

IUD side effects

A

irregular vaginal bleeding, heavier periods, iron deficiency, cramping abdo pain

23
Q

IUD Pros

A
  • No user dependent
  • Lasts 5-10years
  • Does not interfere with sex
  • Does not contain hormoes
  • Can be used as emergency contraception
  • Immediate return to fertility
24
Q

IUD Cons

A
  • Insertion - discomfort and risk

- Periods heavier/painful/longer

25
Q

Subdermal contraceptive implant

A

68 mg etonorgestrel (30-60 mcg/day),

Licensed for 3 years; Contains barium

26
Q

Subdermal contraceptive implant role

A

Prevention of ovulation and implantation, thickens mucus

27
Q

Subdermal implant risks

A

bleeding, bruising, haematoma, infection, allergic reaction, scar, lost implant

28
Q

Subdermal implant side effects:

A

depression, reduced libido, headache, acne, irregular vaginal bleeding, breast tenderness

29
Q

Subdermal implant Pros

A
  • No user dependent
  • Lighter period
  • Does not interfere with sex
  • No hormoes
  • Fertility returns soon after removal
  • Safe in breast feeding
30
Q

Subdermal implant Cons

A
  • Insertion/Excision surgery
  • irregular vaginal bleeding
  • does not prevent STI
  • can interact with other medications
31
Q

Contraceptive injection

A

Depo provera,

150 mg medroxyprogesterone acetate

32
Q

Contraceptive injection risks

A

reduce mineral bone density, local infection, allergic reaction

33
Q

Contraceptive injection side effects

A

Anorgasmia, depression, anxiety, reduced libido, acne, rash, headache, loss of bone density, osteoporosis, bloating, nausea, breakthrough bleeding

34
Q

Contraceptive injection Pros

A
  • Less prone to user failure
  • Does not interfere with sex
  • Can be used in breast feeding
  • periods less heavy/none
35
Q

Contraceptive injections Cons

A
  • Unacceptable bleeding pattern
  • Delays fertility return
  • Weight gain
  • Does not protect from STI
36
Q

POP role

A

(synthetic progesterone) • Thickens mucus, may inhibit ovulation

37
Q

POP Pros

A
  • helps with pain,PMS
  • does not interfere with sex
  • Safe in breast feeding
38
Q

POP cons

A
  • Tight interval window
  • Does not protect from STI
  • can interact with other meds
  • Irregular vaginal bleeding
39
Q

Lactational amenorrhoea (as a contraception)

A
  • No periods since birth
  • bebo <6 months
  • exclusively breastfeeding
40
Q

Contraception and enzyme inducing drugs (epilepsy)

A

Progesterone only injectable; IUD; IUS

Obs and Gynae Y4 (22 decks)

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