Combined_Contraceptive_Patch_Flashcards
What is the only combined contraceptive patch licensed for use in the UK?
The Evra patch is the only combined contraceptive patch licensed for use in the UK.
How long does the patch cycle last for the Evra patch?
The patch cycle for the Evra patch lasts 4 weeks.
How is the Evra patch worn during the patch cycle?
For the first 3 weeks, the Evra patch is worn every day and needs to be changed each week. During the 4th week, the patch is not worn.
What happens during the 4th week of the Evra patch cycle?
During the 4th week of the Evra patch cycle, there will be a withdrawal bleed.
What should be done if the patch change is delayed at the end of week 1 or week 2 for less than 48 hours?
If the patch change is delayed at the end of week 1 or week 2 for less than 48 hours, it should be changed immediately and no further precautions are needed.
What should be done if the patch change is delayed at the end of week 1 or week 2 for more than 48 hours?
If the patch change is delayed at the end of week 1 or week 2 for more than 48 hours, the patch should be changed immediately and a barrier method of contraception used for the next 7 days.
What precautions are needed if the patch change is delayed at the end of week 1 or week 2 for more than 48 hours and unprotected sexual intercourse has occurred?
If the patch change is delayed at the end of week 1 or week 2 for more than 48 hours and unprotected sexual intercourse has occurred in the last 5 days, emergency contraception needs to be considered.
What should be done if the patch removal is delayed at the end of week 3?
If the patch removal is delayed at the end of week 3, the patch should be removed as soon as possible and the new patch applied on the usual cycle start day for the next cycle, even if withdrawal bleeding is occurring. No additional contraception is needed.
What should be done if the patch application is delayed at the end of a patch-free week?
If the patch application is delayed at the end of a patch-free week, additional barrier contraception should be used for 7 days following any delay at the start of a new patch cycle.
Where can further information be found on combined hormonal methods of contraception?
Further information can be found in the NICE Clinical Knowledge Summary on combined hormonal methods of contraception.
summarise combined contraceptive patch
Combined contraceptive patch
The Evra patch is the only combined contraceptive patch licensed for use in the UK. The patch cycle lasts 4 weeks. For the first 3 weeks, the patch is worn everyday and needs to be changed each week. During the 4th week, the patch is not worn and during this time there will be a withdrawal bleed.
For delays in changing the patch, different rules apply depending what week of the patch cycle the woman is in.
If the patch change is delayed at the end of week 1 or week 2:
If the delay in changing the patch is less than 48 hours, it should be changed immediately and no further precautions are needed.
If the delay is greater than 48 hours, the patch should be changed immediately and a barrier method of contraception used for the next 7 days. If the woman has had sexual intercourse during this extended patch-free interval or if unprotected sexual intercourse has occurred in the last 5 days, then emergency contraception needs to be considered.
If the patch removal is delayed at the end of week 3:
The patch should be removed as soon as possible and the new patch applied on the usual cycle start day for the next cycle, even if withdrawal bleeding is occurring. No additional contraception is needed.
If patch application is delayed at the end of a patch-free week, additional barrier contraception should be used for 7 days following any delay at the start of a new patch cycle.
For further information please see the NICE Clinical Knowledge Summary on combined hormonal methods of contraception: http://cks.nice.org.uk/contraception-combined-hormonal-methods#top
A 23-year-old female presents to your GP clinic on Monday morning, worried as she took off her week 2 contraceptive patch on Friday evening, and she was unable to obtain a replacement over the weekend. She has not been sexually active in the last 10 days.
What is the most appropriate action to take?
No action required
No emergency contraception required, but apply new patch and advise barrier contraception for the next 7 days
Issue emergency contraception, apply new patch and advise barrier contraception for the next 7 days
Replace patch immediately, no additional precautions required
Continue patch-free period for 7 days and then replace patch
No emergency contraception required, but apply new patch and advise barrier contraception for the next 7 days
Action required if delayed patch change over 48 hours: barrier protection for 7 days and emergency contraception if required
In this case, there has been a delayed patch change of over 48 hours, but no sexual activity within the past 10 days. Therefore, emergency contraception is not currently required, however she must use barrier contraception for the next 7 days and apply a new patch immediately.
If she was not having sex in the next 7 days, there no action would be required, but you cannot assume this, and should advise her to use barrier contraception over the next 7 days anyway.
The patch should be replaced as soon as possible, to ensure adequate contraceptive cover, therefore option 5 would not be appropriate.
You are in your GP practice and are counselling a 25-year-old female about the contraceptive patch.
What is the correct way to utilise the contraceptive patch effectively?
Change patch fortnightly with no breaks
Wear patch continually for 1 month then have 1 week break
Change patch every 3 days with no breaks
Change patch weekly with a 1 week break after 3 patches
Change patch weekly with no breaks
Change patch weekly with a 1 week break after 3 patches
Contraceptive patch regime: wear one patch a week for three weeks and do not wear a patch on week four
This form of combined contraception is becoming increasingly common as the patch change can be delayed for up to 48 hours without the need for additional contraception. This reduces human error in contraceptive effectiveness. Furthermore, its transdermal absorption means that additional precautions are not required in cases of diarrhoea and vomiting.
This form of contraception is taken similarly to the pill in the sense that there are 3 weeks of contraception use and then a 1 week break when the woman will have a withdrawal bleed. Therefore option 4 is the correct answer in this scenario.
