Contraception Flashcards
Mode of action of:
- COCP, POP, Injectable, Implantable, IUD, IUS
COCP: Inhibits ovulation
POP: Thickens mucus
Desogestrel only, Injection, Implant: Inhibits ovulation (and thickens mucus)
IUD: kills sperm
IUS: prevents endometrial proliferation
Time until each contraceptive is effective
Instant: IUD
2 days: POP
7 days: Others
Missed pill rules for COCP
1 missed pill: take pills and no additional contraception
2 missed pills: take pills and 7 day barrier protection
- week 1: emergency
- week 3: omit pill free period
How long before surgery do you stop the COCP
4 weeks
Which cancers does the COCP increase and decrease risk
Increases risk of BREAST and CERVICAL
Decreases risk of OVARIAN and ENDOMETRIAL
Which contraceptive is the most effective?
Implant
Common SE of the implant and treatment
Unscheduled bleeding
Prescribe 3m of COCP
Where is the implant placed
Subdermal in non-dominant arm
Switching from:
- IUD to COCP
- POP to COCP
IUD to COCP: no additional protection if removed ay 1-5 of cycle
POP to COCP: 7 day barrier protection
Missed pill rules for the POP
Traditional: 3 hours late
Desofestrell (cerazette): 12 hours late
take missed pill and continue pack
barrier protection for 48 hours
Do you need extra protection when on Abx for POP?
No
Counsel a lady on how to apply the patch
1 patch every 3w then 1w break
48 hours late changing the patch then barrier for 7 days
2 side effects of the injection
increases weight and increased return to fertility
what age should you stop the injection
50
how often is the injection needed
every 12 weeks
Can you use oral contraceptives after a gastric bypass
no
do males on female hormones need contraception
yes - sperm are still alive
how effective is lactational amenorrhoea
98% if fully breastfeeding up to 6m
POP postpartum
start anytime, 2 day barrier if starting after 21 days
COCP postpartum
Start after 21 days with 7 days barrier
UKMEC2 6w-6m
UKMEC 4 if breastfeeding
IUD postpartum
In 48 hours or after 4 weeks
Which is the most effective form of emergency contraception and when can it be used
IUD
Within 5 days or 5 days after ovulation
MOA and trade name of Levonorgesterol
Stops ovulation and inhibits implantation
Levonelle
MOA and trade name of Ulipristal
Inhibits ovulation
ELLAONE
Dosages of Levonelle and Ellaone
Levonelle: 1.5mg (double if BMI above 26 or weight above 70kg, repeat dose if vomit in 3 hours)
Ellaone: 30mg
When is Ellaone and Levonelle effective
Ellaone: within 120 hours
Levonelle: within 72 hours
When can you start hormonal contraception after Ellaone and Levonelle
Ellaone: in 5 days (1w break if breastfeeding)
Levonelle: immediately
Which emergency contraception needs caution in asthma
Ellaone (ulipristal)
Give 1 absolute contraindication to the IUD
PID
When in the cycle should the IUD be inserted
Any stage
UKMEC
UK Medical Eligibility Criteria
(learn them lol)
