Contraception Flashcards
When is ulipristal acetate C/I?
Severe asthma
After which emergency contraception do you need to wait before restarting the pill/patch/ring?
How long should you wait for?
Additional advice?
Ulipristal
5 days
condoms 7 days
How does levonorgestrel work?
stops ovulation and inhibits implantation
When to double dose of levonorgestrel?
the dose should be doubled for those with a BMI >26 or weight over 70kg
How long after UPSI can you use
1) Levonorgestrel
2) Ulipristal
1) 72h
2) 5 days
How does ulipristal work
inhibition of ovulation
After which EC should you delay breastfeeding and for how long
Ulipristal
7 days
When can you fit copper coil for EC?
After 5 days UPSI OR
5 days after ovulation
UKMEC 3 for COCP
- More than 35 years old and smoking less than 15 cigarettes/day
- BMI > 35 kg/m^2*
- Family history of thromboembolic disease in first degree relatives < 45 years
-Controlled hypertension
-Immobility e.g. wheel chair use
-Carrier of known gene mutations associated with breast cancer (e.g. BRCA1/BRCA2)
-Current gallbladder disease
UKMEC4 COCP
-More than 35 years old and smoking more than 15 cigarettes/day
-Migraine with aura
- History of thromboembolic disease or thrombogenic mutation
-History of stroke or ischaemic heart disease
-Breast feeding < 6 weeks post-partum
-Uncontrolled hypertension
-Current breast cancer
-Major surgery with prolonged immobilisation
-Positive antiphospholipid antibodies (e.g. in SLE)
COCP mechanism
Inhibits ovulation by acting on hypothalami-pituitary axis
POP mechanism
Thickens cervical mucus
Injectable contraceptive (medroxyprogesterone acetate) Mechanism
Inhibits ovulation and also thickens mucus
Implant mechanism?
Inhibits ovulation and also thickens mucus
IUD mechanism
Decreases sperm motility and survival
