Contraception Flashcards
What are some examples of LARCs (long acting reversible contraception)?
Implantable contraception
Injectable contraceptives
Intrauterine system (IUS) - progesterone releasing coil
Intrauterine device (IUD) - copper coil
What is the method of action of the COCP?
Inhibits ovulation
What is the method of action of the POP?
Thickens cervical mucus
What is the method of action of injectable contraceptives e.g., medroxyprogesterone acetate)?
Primarily inhibits ovulation
Also thickens cervical mucus
How long does the medroxyprogesterone acetate injection provide contraception for?
12 weeks
What is the mechanism of action of the implant?
Primary - inhibits ovulation
Also works to thicken the cervical mucus
How does the IUD (copper coil) work?
Decreases sperm motility and survival
How does the intrauterine system work?
Primarily works to prevent endometrial proliferation
Also thickens cervical mucus
What are the 2 methods of emergency contraception that are avaliable?
Emergency hormonal contraception - levonorgestrel, or ulipristal
IUD - copper coil
How long after unprotected sex is levonorgestrel effective?
72 hours
What is the dose of levonorgestrel?
Single dose is 1.5mg
This should be doubled in those with a BMI >26, or if weigh more than 70kg
True or False?
Hormonal contraception can be restarted straight after taking levonorgestrel as an emergency contraceptive?
True - hormonal contraception can be restarted immediately
How long after unprotected sex can ulipristal be taken as an emergency contraception?
120 hours
What is the dose of ulipristal?
30mg
True or False?
Hormonal contraception can be restarted straight after taking ulipristal as an emergency contraceptive?
False - ulipristal can reduce the effectiveness of hormonal contraception
contraception via the patch, pill or ring can be started/restarted after 5 days. Barrier methods should be used in the meantime
True or False?
It is safe to breastfeed after taking emergency contraception?
False
It should be stopped for one week following a dose of ulipristal
It is safe to breastfeed as normal with levonorgestrel
What is the most effective form of emergency contraception?
IUD
When can an IUD as emergency contraception be used?
Within 5 days of unprotected sex
OR
If presents after 5 days, the IUD can be fitted up to 5 days before the likely ovulation date
How long after giving birth would someone require contraception?
After 21 days
How long after childbirth can an IUD or IUS be inserted?
Within 48 hours
OR
After 4 weeks
What method of oral contraception is contraindicated in breast-feeding people?
COCP
How effective is LAM (Lactational Amenorrhea Method) as a form of contraception?
98% effective if fully breastfeeding, ammenorheic and <6 months post-partum
What is the advice given for 1 missed dose of the COCP?
Take the pill as soon as you remember then continue taking pill as normal
What is the advice for more than 2 missed doses of the COCP?
Take the last pill missed, even if this means taking 2 pills in one day. Skip any earlier missed pills
Use barrier methods or abstain from sex until the COCP has been taken for 7 consecutive days
If 2 or more pills are missed in week 1 (days 1-7) what additional advice should be given (COCP)?
If the patient has had unprotected sex during the pill-free interval or during week 1, consider emergency contraception
If 2 or more pills are missed in week 3 (days 15-21) what additional advice should be given (COCP)?
Finish the pills in the current pack then start the next pack straight away (on day 22) omitting the pill free interval
What is the advice regarding a late dose of traditional POP?
Less than 3 hours late - take the pill as normal
More than 3 hours late
- take missed pill ASAP. If more than 1 is missed, just take 1. Take the next pill at usual time (even if that means taking 2 in one day
- continue with the rest of the pack
- extra precautions should be taken until pill taking has been re-established for 48 hours
What is the advice regarding a late dose of Cerazette (new POP)?
Less than 12 hours late - take the pill as normal
More than 12 hours late
- take missed pill ASAP. If more than 1 is missed, just take 1. Take the next pill at usual time (even if that means taking 2 in one day
- continue with the rest of the pack
- extra precautions should be taken until pill taking has been re-established for 48 hours
