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Obstetrics > Contraception > Flashcards

Contraception Flashcards

1
Q

Which forms of contraception are >99% effective?

A
  • IUD / IUS
  • Sterility (oophorectomy) / vasectomy
  • progesterone implant
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2
Q

Contraceptive advice for someone at high risk of breast Ca?

A
  • use barrier contraception or copper coil
  • avoid any hormonal contraception
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3
Q

Contraceptive advice for someone at high risk of cervical / endometrial Ca?

A

avoid Mirena coil

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4
Q

Contraceptive advice for someone with Wilson’s disease?

A

avoid copper coil

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5
Q

How long is contraception required for in postmenopausal women?

A

2 years if under 50 and 1 year if over 50

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6
Q

When is contraception required again after childbirth?

A

after day 21

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6
Q

UKMEC 4 for COCP?

A
  • uncontrolled HTN
  • migraine with aura
  • history of VTE
  • > 35 years old smoking 15+ a day
  • vascular disease inc stroke and IHD
  • cardiomyopathy or AF
  • liver cirrhosis or liver Ca
  • SLE or APS
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7
Q

Can the COCP be used after childbirth?

A

Yes but should be avoided if breastfeeding (it is expressed in milk)

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7
Q

When can the copper coil / Mirena be inserted after childbirth?

A

either within 48h of childbirth or after 4 weeks

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8
Q

What are the options for barrier contraception?

A
  • condoms (82% effective with typical use)
  • diaphragms
  • cervical caps (use these and diaphragms with spermicidal gel)
  • dental dams
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8
Q

Primary mechanism of action of COCP?

A

inhibits ovulation

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9
Q

What are the 3 different cyclical ways of taking the COCP?

A
  • 21 days on and 7 days off
  • 63 days on and 7 days off (tricycling)
  • continuous
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10
Q

Which conditions does the COCP increase the risk of?

A
  • VTE
  • breast Ca
  • cervical Ca
  • MI, stroke
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11
Q

When is additional protection needed alongside starting the COCP? For how long?

A
  • anytime after day 5 of menstrual cycle
  • use condoms for 7 days
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11
Q

Which conditions does the COCP reduce the risk of?

A
  • menorrhagia and dysmenorrhoea
  • endometrial Ca
  • ovarian Ca
  • colorectal Ca
  • benign ovarian cysts
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12
Q

Missed pill advice less than 72 hours since it was last taken?

A
  • take the missed pill asap even if it means 2 pills in a day
  • no extra protection required
13
Q

Missed more than 1 pill in last 72 hours?

A
  • take most recent missed pill asap even if it means 2 pills in a day
  • condoms for 7 days
14
Q

Missed more than 1 pill in last 72 hours and has had unprotected sex in day 1-7 of pack?

A

Emergency contraception needed

15
Q

Missed more than 1 pill in last 72 hours and has had unprotected sex in day 8-14 of pack?

A

No emergency contraception needed

16
Q

Missed more than 1 pill in last 72 hours and has had unprotected sex in day 15-21 of pack?

A
  • No emergency contraception needed
  • Skip pill free period
17
Q

What is the perioperative advice for the COCP?

A

To stop 4 weeks before any major surgery

18
Q

UKMEC 4 for POP?

A

Active breast Ca

19
Q

Key difference between traditional POP and desogestrel only pill?

A
  • POP cannot be taken >3 hours late
  • desogestrel can be taken up to 12 hours late
19
Q

Mechanism of action of traditional POP?

A

Thickens cervical mucus

20
Q

Mechanism of action of desogestrel pill?

A

Inhibits ovulation

21
Q

When is additional protection needed after starting the POP?

A
  • not needed if day 1-5 of cycle
  • 2 days of condoms if any other stage of cycle
  • you can switch between POPs without needing any extra protection
21
Q

Which conditions does POP increase the risk of?

A
  • ovarian cysts
  • ectopic pregnancy (but not desogestrel)
  • breast Ca (minimal)
22
Q

Side effects of POP?

A
  • irregular, prolonged or troublesome bleeding
  • breast tenderness
  • headache
  • acne
22
Q

Why is the depot injection less effective (94%) with typical use than perfect use (99%)?

A

many women forget to book in to get it again at 12-13 weeks

23
Q

UKMEC 4 for depot injection?

A

active breast Ca

24
Q

Mechanism of action of depot injection?

A

inhibits ovulation

25
Q

Side effects and risks of depot injection?

A
  • weight gain
  • increased risk of osteoporosis (reduces bone mineral density)
  • irregular bleeding for up to 6 months
  • reduced libido
  • alopecia
26
Q

Possible benefits of depot injection?

A
  • improves dysmenorrhoea
  • improves endometriosis
  • reduces ovarian and endometrial Ca risk
  • reduces risk of sickle cell crisis in SCA
27
Q
A

Obstetrics (2 decks)

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