contraception Flashcards
absolute contraindications to COCP UKMEC 4
smoker over age of 35 who smokes > 15 a day
obesity
breast feeding < 6 weeks postpartum
fmily history of thrombosis < 45 years old
breast cancer
BRCA genes
cancer within last few years
disadvantages outweigh advantages in COCP UKMEC3
breast feeidng > 6 weeks
previous clots
continued use after heart disease or stroke
moigraine w aura
active liver or gallbladder disease
missed pill rules
if pill missed in week 1: use emergency contraception if unprotected sex in pill free interval
if pill missed in week 2: no need for emergency contraception
if pill missed in week 3: take last pill that was missed, finish current pack and start next pack immediately
patients should not take more than 2 pills in a day ever no matter how many were missed
if patients sick within 3 hours of taking combined pill or 2 hours of progesterone only then what
take another pill straight away
take next pill as usual
does missing one COCP pill compromise effectiveness
no, one pill is not cause for concern
protection from days before and after
does missing one progesteron only pill compromise effectiveness
yes
only effective on the day taken. missing even one day reduces effectiveness
use condoms for next 2 days and if unprotected sex happens in these 2 days then use emergency contraception
when are progesterone only pills considered late
desogestrel 12 hours
norethisterone 3 hours
how many days post unprotected sex can IUD be used
five days post sex or five days post earliest possible ovulation
how many days post unprotected sex can ellaOne - ulipristal acetate- be used
five days post sex
wait 5 days before starting ongoing contraception
selective progesterone receptor modulator
suppresses LH surge and delays ovulation
has an antiglucocorticoid effect so not suggested in severe asthma
how many days post unprotected sex can levonelle- levonorgestrel- be used
within 3 days
dose doubled if patients BMI is >26 or weight is >70kg
inhibits or delays ovulation and thickens cervical mucus
can quick start ongoing contraception
surgery advice for pill
stop pill four weeks before surgery, commence alternative form in interim and restart 2 weeks after
increases risk of venous thromboembolism
rule of thirds progesterone only contraceptive
women stop having periods
continue as normal
spotting and irregular bleeds
contraindications of IUD
active STI
history of frequent STIs
distorted uterus
unexplained bleeding
abnormal cervix
link with cancer OCP
reduces risk of colorectal, endometrial and ovarian
increases risk of breast and cervical cancer
how to work out likely ovulation date
14 days before the next cycle so
so if normally 28- 14 = 14
then have up until day 19 to take IUD
