Contraception Flashcards
LARC?
Long acting reversible contraception
On which days of the cycle if there highest chance of pregnancy from sex?
Days 8-19
What two hormones are found in the combined hormonal contraction?
Oestrogen- synthetic type called ethinyl estradiol
Progesterone
When may the combined pill may not be suitbale?
If the individual has frequent GI upset
How often in the combined patch changed?
Weekly
What is one of the side effects of the combined patch?
Skin reaction to the glue
How often in the combined vaginal ring changed?
Every 3wks
->can take out for 3hrs every 24hrs without loosing the contraceptive benefit, so some take it out for sex. This is okay.
What are some of the non-contraceptive benefits of the combined hormonal methods?
Regulates/reduces bleeding
Reduction in functional ovarian cysts
50% reduction in ovarian and endometrial cancer
Improve acne
Reduction in benign breast disease, rheumatoid arthritis, colon cancer and osteoporosis
What are some of the side effects of the combined hormonal contraceptive methods?
Breast tenderness
Nausea
Headache
Irregular bleeding
Mood changes
Weight gain
What are some of the more serious risks of taking the combined hormonal methods of contraception?
Increased risks of:
DVT/PE
MI/ischaemic stroke
Cervical cancer*
Breast cancer
->*this data was before the HPV vaccine so may not be as strong links now
Who needs to avoid taking combines hormonal methods of contraception?
Those with active gall bladder disease or previous liver tumour
How often does the combined hormonal pill have to be taken?
Every day, doesn’t really matter what time.
->Usually 3wks and then a week off but this is less common now, lots of people take it continually
How often is the progestogen only pill taken?
Every day at the same day
->not a good choice if frequent GI upset
Contraindications for the progestogen -only pill?
Personal history of breast cancer/liver tumour
Side effects of the progestogen only pill?
Appetite increase
Hair loss/gain
Mood change
Bloating or fluid retention
Headache
Acne
Describe what is meant by injectable progestogen .
Dose of progesterone every 13wks, usually given in buttock by health professional but possible for smaller dose to be self administered in abdomen/thigh
How does the progestogen injection work?
- Prevents ovulation
- Alters cervical mucus making it hostile for sperm
- Makes endometrium unsuitable for implantation
Disadvantages of injectable progestogen ?
Delay in return to fertility- 9 months
Reversible reduction in bone density
Problematic bleeding, especially in first two doses
Weight gain
How long can the progestogen implant work for?
3yrs
What is bleeding like on the progestogen implnt?
60% almost bleed free
30% have prolonged/frequent bleeding
->worth noting that it seems this implant causes mood changes more than other progestogen methods
What are some of the risks of intrauterine contraception like coils
?
Small risk of infection
Very small risk of perforation of uterus
Risks of expulsion
Risk of ectopic pregnancy
How does the copper coil work?
Toxic to sperm so kills them and stops them reaching the egg
How long does the copper coil work for?
5-10yrs depending on type
->if fitted after 40th birthday, can last until menopause
What effect does the copper coil have on periods?
Can make them heavier/crampier
Is a copper coil a contraindication to MRI?
No
->i found this interesting haha
Mirena coil is a type of Levonorgestrel IUS. How long does it last?
8yrs
As well as being contraceptive, what can the Mirena coil be used for?
Heavy menstrual bleeding
What is the most effective option for emergency contraception?
Copper coil
->levonorgestrel pill or ulipristal pill may be taken instead but slightly higher risk of pregnancy still occurring
How quickly after delivery can you fall pregnant again?
21 days
How long is breast feeding contraceptive for?
First six months
->some conditions through: must be exclusively breastfeeding and feeding every 4hours. Must be amenorrhoeic
How long after a miscarriage or abortion can a women fall pregnant again?
After 5 days
What happens in female sterilization?
Clips applied across fallopian tubes under laparoscopy
->may do salpingectomy at planned caesarean section if baby seems well and discussed in advance
What effect does female sterilization have on periods?
No effect
->also worth noting that female sterilization reduces risks of ovarian cancer
What happens in a vasectomy?
Vas deferens divided and the ends are cauterised
How long after does a vasectomy take to be effective contraception?
4-5months
If a women has had sterilization, how is the only way she can call pregnant?
IVF
->will be private and self funded
What are the risks of abortion?
Infection
Blood transfusion
Abortion can be carried out medically or surgically. What happens if carried out surgically?
Transcervcal, suction catheter used
Abortion can be carried out medically or surgically. What happens if carried out medically?
Mifepristone oral antiprogestogen tablet
36-48hrs later, Misoprostol tablet taken.
Misoprostol initiates uterine contraction which expels pregnancy
Potential complications of surgical abortion?
Perforation
Cervical injury
Potential complications of medical abortion?
Failure of termination
