Contraception Flashcards
Combined oral contraceptive pill
increased risk of breast and cervical cancer
protective against ovarian and endometrial cancer
Which form of contraception is absolutely contraindicated while breast feeding?
Combined contraceptive pill
Intrauterine devices (IUD)
commonly make periods heavier and more painful. This is the most likely explanation for this lady’s symptoms.
28-year-old woman who has presented with lower abdominal pain and vaginal bleeding. Two weeks ago she had a intrauterine device (IUD) fitted as emergency contraception after presenting 6 days post unprotected intercourse. The pain is describe as being like severe dysmenorrhoea and is worse in the right iliac fossa. Her bleeding has been continuous for the past 6 days. Her normal menstrual cycle is 28 days long with 4 days of bleeding. She is eating and drinking normally.
On examination temperature is 36.5ºC, blood pressure 104/68mmHg. She has mild tenderness in the right iliac fossa with no guarding.
Urine dip: NAD
Urine hCG: Negative
A 27-year-old female asks for advice regarding the Mirena (intrauterine system). What is the most likely effect on her periods?
Initially irregular bleeding later followed by light menses or amenorrhoea
This is because the Mirena intrauterine system (IUS) releases a small amount of the hormone levonorgestrel into the uterus. This hormone has multiple effects, one of which is to thin the lining of the uterus which reduces menstrual flow and can lead to amenorrhoea in some women. Initially, this may cause irregular spotting or light bleeding but over time (usually within 3-6 months), periods tend to become lighter and less painful, and some women stop having periods altogether.
Which one of the following is an absolute contraindication to combined oral contraceptive pill use?
Migraine with aura
The presence of aura in migraines is a significant risk factor for ischemic stroke, and when combined with the prothrombotic effect of oestrogen found in combined oral contraceptives, this risk is further amplified.
Contraceptives - time until effective (if not first day period):
instant: IUD
2 days: POP (Cerazette (desogestrel))
7 days: COC, injection, implant, IUS
Which one of the following methods of contraception is proven to be associated with weight gain?
Depo Provera (Medroxyprogesterone acetate)
The Depo Provera is the only method of contraception which has a proven link with weight gain. Other adverse effects include a delay of up to 1 year in the resumption of fertility, increased risk of osteoporosis and irregular bleeding.
A woman presents to have a Nexplanon (etonogestrel) inserted. Where is the most appropriate place to insert the implant?
Subdermal, non-dominant arm
Subdermal, non-dominant arm.This location allows for easy insertion and removal, while also minimising interference with daily activities. It is recommended by the Faculty of Sexual and Reproductive Healthcare (FSRH) guidelines.
