COC/Patch/Ring Flashcards
Mode of action
Prevents ovulation (-ve feedback on Gn release) Thickens cervical mucus Thins endometrium
What is the failure rate of COC?
0.2%
8% in first year
When should this method be started?
Most women can start it at any time in their cycle.
1st day gives immediate protection (or first 5 days, unless shorter cycles). Otherwise protection takes 7 days
What are causes of failure of COC/Patch/Ring?
Interaction with:
Rifampicin and Rifabutin (TB and meningitis)
What are causes of failure of COC/Patch/Ring?
Common enzyme inducers: Rifampicin and Rifabutin (TB and meningitis) Anti-epileptics St John's Wort Anti-retrovirals
At what age should combined hormonal contraception be stopped?
35 if smoker or only stopped smoking 1 year before and over 35
Menopause
Risk factors for VTE
How is the patch used?
1 per week for 3 weeks, then 1 week break
How is the vaginal ring used?
You can start using the vaginal ring at any time during your menstrual cycle. You leave it in for 21 days, then remove it and have a seven-day ring-free break.
Benefits of Combined (oestrogen+progesterone) contraception
Regulates Menstrual cycle ↓Ovarian Cysts ↓Hirstutism/Acne ↓Ovarian/Endometrial Cancer Tx symptoms of Endometriosis
Risks of combined contraception
VTE Ischaemia Stroke Migraine Breast Cancer (beware Family Hx) Cervical Cancer 0.2/100 failure rate
AFFECTED by antibiotics
Contraindications to combined contraceptives
VTE/Ischaemia/HTN Migraines Active breast/Cervical cancer Thrombophilia Pregnancy Liver disease >35yrs + >15 cigs BMI >40 Diabetes + Complications
Progestogenic side effects
Depression Mood swings Abnormal Bleeding Acne Breast tenderness Weight Gain ↓Libido
Oestrogenic side effects
Nausea
Headaches
Fluid retention
Breast tenderness
Abnormal Bleeding
Breakthrough bleeding in first 3 months is common
