Contraception Flashcards
How many days after childbirth does fertility return?
21 days
2 contraindications to COCP
wheelchair use
breastfeeding in first 6 weeks postpartum
Where is the implant placed
subdermal
When can you insert a copper coil for emergency contraception
Up to 5 days after unprotected sex OR 5 days after the ovulation date
What would you do if a women missed 1 COCP
They should take their missed dose as soon as possible with no extra precautions
What would you do if a women missed 2 COCP in week 1
They should take both pills today
Consider emergency contraception if she had unprotected sex during the pill-free interval or in week 1
What would you do if a woman missed 2 COCP in week 2?
No emergency contraception is needed, as long as the previous 7 days of COCP have been taken correctly
What would you do if a women missed 2 pills in week 3?
Finish the pills in the current pack and start the new pack immediately, omitting the pill-free period
Why should the COCP NOT be used in the first 21 days post partum?
Increased risk of VTE
When switching from an IUD to COCP is additional contraception needed?
No, if the IUD is removed in day 1-5 of the cycle
How long do you have to wait until the POP is effective?
48 hours
Which contraceptive should patients who have been assigned female at birth avoid if they are undergoing testosterone therapy
Contraceptives containing oestrogen as they can antagonise the effect of testosterone therapy
Does testosterone therapy protect against pregnancy?
No
and testosterone is teratogenic
What should trans female (assigned males) use as contraception?
Condoms
Give one example of a contraindication for injectable progesterone contraceptives
Current breast cancer
What should a women do if she is on the POP and required antibiotics
Nothing, there is no need for any extra precautions
What medication should be used with caution in patients with severe asthma
Ulipristal
Give one absolute contraindication for the copper IUD
Pelvic inflammatory disease
At what age should you stop implantable contraceptives
50
Which contraception has the longest delay in return to fertility
Depot injection
How long do you need to wait after having Levonelle (levonorgesterel) for emergency contraception to restart the COCP or start it for the first time
Restart the COCP immediately after emergency contraception
How long will it take until each contraceptive is effective (if not the first day period)?
Instant: IUD
2 days: POP
7 days: COC, implant, IUS
When can the IUD or IUS be inserted after childbirth?
Within 48 hours or after 4 weeks
When switching from a POP to COCP do you need additional barrier contraception?
Yes, 7 days of barrier contraception
Elective surgery COCP
Stop immediately and switch to POP
What cancers does the COCP increase and decrease the risk of?
Increased risk of breast and cervical
Decreased risk of ovarian and endometrial
When do women no longer need contraception?
Over 50 and amenorrhoeic for over 12 months
Under 50 and amenorrhoeic for over 24 months
When can the combined contraceptive pill be given postpartum?
It can be given if requested 6 weeks postpartum even if breastfeeding BUT they can get pregnant from 21 days postpartum so they need a pregnancy test before starting
What is the most appropriate contraception to consider when taking a long term antibiotic
Depo injection (for abx that are enzyme inducers e.g. rifampixin)
Is there any need for extra precautions with the POP and ABx
No
Migraine with aura even if just pins and needles up arm
Primary mode of action of the contraceptive implant
Inhibition of ovulation
Suspected STI and 5 days post intercourse
Ulipristal acetate (EllaOne)
How long should you wait after ulipristal (ellaone) before restarting hormonal contraception
5 days
What contraception can you not take with epilepsy drugs?
Hormonal
So use copper coil instead
How long are each of the emergency contraceptives effective for?
EllaOne (ulipristal): 120 hours
Levonorgestrel: 72 hours
IUD: 5 days
Which contraceptive method has no UKMEC caution for migraine with aura
Copper coil
Absolute contraindication for injectable progesterone contraceptives
Current breast cancer
What does the Pearl Index describe
the number of pregnancies that would be seen if one hundred women were to use the contraceptive method in question for one year
0.2 = 0.2/100 or 2/1000
When can you restart the COCP after surgery
2 weeks after
Women over 35 smoking more than 15 cigarettes a day - what contraception is contraindicated
All combined hormonal contraception
Main adverse effect of the implant
Irregular menstrual bleeding
What emergency contraceptive should be used caution with patients with severe asthma
Ulipristal (EllaOne)
