Contraception Flashcards
IUD Mechanism of Action
Prevents Fertilization and Implantation
LNG Method of Action
Delays ovulation up to when LH Surge STARTS
UPA Method of Action
Delays Ovulation up to when LH Surge PEAKS
uPa - Peaks
Up to when can you give LNG?
72 Hours
3 Days
Up to when can you give Ulipristal?
120 Hours
(5 Days)
Gai te2oli delwakty ?
When can you fit emergency IUD
5 Days after UPSI
or
5 Days after earliest ovulation
When method is affected by enzyme inducers?
UPA (Avoid it)
Double LNG dose
Enzyme inducers
Anti-Epileptics Anti-retroviral Anti-tb Saint John's (Ditch UPA and double LNG)
Drug interactions with UPA
Enzyme Inducers
Drugs that increase gastric pH
Ulipristal contraindications
Severe Asthma `
LNG Contraindications
No contraindications
Double when using enzyme inducers
Why is Ulipristal contraindicated in severe asthma?
Anti glucocorticoid effect of UPA
Severe asthma controlled by glucocorticoid
Ulipristal medical contraindications
Severe Asthma Breast Feeding (Discard milk for 7 days)
Weight and contraceptives
LNG Less effective
70+ Kg or BMI >26
Effects of LNG / UPA on pregnancy / fetus
Safe
When can you start taking hormonal contraceptives after LNG / UPA
LNG - Right away
UPA - 5 Days after
UPA and hormonal contraception
Wait 7 days after hormonal contraceptive to give UPA
Wait 5 days after UPA to give hormonal contraception
Contraindicated drugs / UPA
Oral Steroids
Drugs that reduce pH
Enzyme Inducers
Hormonal Contraception (5 after / 7 days before)
Vomiting after oral ec management
Repeat Dose
or
Consider IUD
Effect of EC on period
Starts within 7 days of expected time
Irregular Bleeding
How long does unfertilized egg last for?
24 Hours
Ovulation date calculation
Period length - 14 Days
Earliest Ovulation Calculation
When is the earliest ovulation after giving birth ?
21 Days (3 Weeks) (Start contraception after giving birth by 3 weeks)
Earliest ovulation after ectopic / miscarriage / abortion
8 Days
Start contraception within 5 days
How long does it take fertilized egg to implant ?
5 Days
How long after UPSI should you do pregnancy test?
3 Weeks
How many days does the sperm survive?
5 Days
How many days does it take for fertilized egg to implant
5 Days
Physiology of LAM
Prolactin Increase - Reduced Gonadotrophins Release - Reduced LH / FSH
When is LAM effective
Full Breast Feeding
No Periods
Less than 6 months post partum
Spermicide
Apply 15 Mins Before
No douching 6 hours after
How does estrogen work as a contraceptice?
Inhibits ovulation through suppression of axis
Why is progesterone given with estrogen
Balance
Add Suppressive effect on axis
Combined pills method of action
Used for 21 days - endometrium support
Withdrawal bleeding 2/3 days after stopping
Start new course on 5th day
How do OCP work ?
Inhibition of ovulation
Increasing tube secretions
Edema / Atrophy of EM Glands
Which cancers are reduced with OCP
EM (Opposing Progesterone) Ovarian Endometriosis (Opposing Progesterone)
Which cancers are reduced with OCP
EM (Opposing Progesterone) Ovarian Endometriosis (Opposing Progesterone)
OCP Side effects
TE Disorders
Liver (Cholestasis)
Decreased lactation (Estrogen Effect)
Depo Provera Dose
150mg IM Every 3 Months
UO Quadrant Buttock
Sayana Press Dose / Application
104mg
Abdomen
Side effects of shots
Depression
Weight Gain
Delay in fertility return
