contraception Flashcards
what are the types of contraception
- combined hormonal contraception
- progestogen only method
- intrauterine contraception
- emergence contraception
- sterilisation
what is the pearl index
number of pregnancies per 100 women per years of exposure
what is life table analysis
pregnancy rate over a specified time frame
what is the benefit of long active reversible contraception (LARC)
less user input so minimises user failure rates
what are the types of combined hormonal contraception
- pill (daily)
- patch (changed weekly)
- vaginal ring (changed every 3 weeks)
what does combined hormonal contraception consist of
ethinyl estradiol & synthetic progestogen
what are the benefits of combined hormonal contraception
- stops ovulation (helps with PMS)
- reduces bleeding
- reduction in ovarian cysts
- improves acne/hirsutism
- reduction in benign breast disease, rheumatoid arthritis, colon cancer and osteoporosis
what are side effects of combined hormonal contraception
- breast tenderness
- nausea
- headache
- irregular bleeding for first 3 months
- venous thrombosis (DVT, PE)
- arterial thrombosis (MI, ischaemic stroke)
- cervical/breast cancer
what are precautions of combined hormonal contraception
avoid if active gall bladder disease or previous liver tumour
what are the types of progestogen only methods
- pill (desogestrel)
- jag
- implant
what are the benefits of progestogen only methods
- oestrogen free so few contraindications
- all cycles anovulant
- alters cervical mucus
what are the side effects of progestogen only methods
- headache
- hair loss/gain
- acne
- apetite increase
- bloating/fluid retention
- mood change
what are the types of intrauterine contraceptions
- the coil
- copper IUD (hormone free; lasts 5-10 years)
- levenorgestrel IUS (slow release progestogen - mirena, kyleena)
what are the types of emergency contraception
- copper IUD (within 120 hours UPSI or by day 19)
- levonorgestrel pill (within 72 hours)
- ulipristal pill (within 120 hours; contraindications with breastfeeding/enzyme inducing drugs)
when to start contraception
start in first 5 days of cycle for immediate cover
when can you get pregnant
21 days after delivery
5 days after miscarriage/abortion
how long is breastfeeding contraceptive for
first 6 months + feeding every 4 hours + amenorrhoeic
what are some enzyme inducing drugs
carbamazepine
topiramate
rifampicin
st john’s wort
what do enzyme inducing drugs do
increase metabolism of progestogen and oestrogen
reduce effectiveness of combined pill, patch and ring, POP and implant
progestogen injections, copper IUD or levonorgestrel IUS not affected
what are methods for female sterilisation
laparoscopic sterilisation - fishie clips applied across tube to block lumen
