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Reproduction > Contraception > Flashcards

Contraception Flashcards

1
Q

What is the primary mode of action of the COCP?

A

Inhibits ovulation (does this by reducing production of FSH and LH)

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2
Q

What is a secondary mode of action of the COCP?

A

Thickening of cervical mucus

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3
Q

What should a patients blood pressure be below to start the COCP?

A

140/90

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4
Q

You have just started a 29 year old women on the COCP for the first time. When do you need to check her blood pressure?

A

At three months

Anually after that

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5
Q

What COCP is useful if a patients has acne and/or hirsutism?

A

Co cyprindiol (Dianette)

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6
Q

Is the risk of cervical cancer increased or decreased with COCP use?

A

Increased

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7
Q

What two measurments are important to record before the first prescription of the COCP?

A

Blood pressure

BMI

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8
Q

What two cancers is use of the COCP protective from?

A

Ovarian

Endometrial

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9
Q

When can the COCP be started that means no other means of contraception needed from day 1?

A

Up to day 5 of the cycle

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10
Q

If the COCP is started on day 10 of the cycle, how many days will it be until the women has contraceptive cover?

A

7

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11
Q

How long after taking levonelle 1500 should you use a barrier contraception/abstain for?

A

7 days

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12
Q

How long after taking ellaOne how long should you wait before starting contraception?

A

5 days

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13
Q

What should you do if you miss one COCP?

A

Take the missed pill as soon as remembered and take the remaining pills at the normal time. Emergency contraception not required

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14
Q

What should you do if you miss 2 COCP pills?

A

Take the most recent missed pill
Take the remaining pills at the correct time
Use condoms/abstain until 7 pills have been taken consecutively

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15
Q

If you miss more that 2 pills in the last week of a pack what should you do to minimise risk of pregnancy?

A

Omit the next pill free interval

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16
Q

Which week is pregnancy most likely if you have missed two pills and you have had sex?

A

1st week of a pack

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17
Q

How long can a contraceptive patch stay off for before its efficacy is reduced?

A

48 hours

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18
Q

How many days can a patch be worn for before its efficacy is reduced?

A

9 days (7 days + 48hrs)

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19
Q

Describe how you use a contraceptive patch

A

1 patch is applied and worn for 1 week to suppress ovulation. Thereafter the patch is reapplied weekly for a further 2 weeks. The fourth week is patch free to allow a withdrawal bleed.

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20
Q

Describe how you use a vaginal ring?

A

Ring placed in the vagina and left for 21 days. After this there is a ring free interval for 7 days when there will be withdrawal bleed and then a new ring should be inserted

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21
Q

How long can a vaginal ring be out of the vagina for before its efficacy is reduced?

A

48 hours

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22
Q

How long can a vaginal ring be worn for before its efficacy is reduced?

A

4 weeks

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23
Q

Which progesterone out of these 3 is the longest acting:

  • Levonorgestrel
  • Norethisterone
  • Etonorgestrel
A

Etonorgestrel

24
Q

What the primary mechanism of the progesterone only pill?

A

Thickening cervical mucus

25
Q

What is the primary mechanism of the etonorgestrel progesterone pill?

A

Thickening of cervical mucus and suppression of ovulatuon in 97% of cycles

26
Q

What are the secondary mechanisms of the progesterone only pills?

A

Suppression of ovulation
Reduced endometrial receptivity to blastocyst
Reduction in cilia activity in fallopian tube

27
Q

Which progesterone out of these 3 is used in newer progesterone only pills:

  • Levonorgestrel
  • Norethisterone
  • Etonorgestrel
A

Etonorgestrel. Due to it being longer acting

28
Q

Describe how you take the progesterone only pill?

A

Daily at the same time with no break

29
Q

With the older progesterone pills (levonorgestrel & norethisterone) how may hours have should there be between doses?

A

Between 24 - 27 hours

30
Q

With the newer progesterone pills (etonorgestrel) how many hours should there be between doses?

A

24 - 36. Longer window than older POPs

31
Q

How many progesterone only pills do you have to miss to require emergency contraception?

32
Q

List 5 methods of natural family planning

A
  1. Basal body temperature
  2. Cervical mucous thickness
  3. Cervical position
  4. Calculating fertile days
  5. Breastfeeding
33
Q

What is the position of the cervix when you are fertile?

A

High in the vagina, soft and open

34
Q

What is the position of the cervix when you are less fertile?

A

Low in vagina; firm and closed

35
Q

In a 28 day cycle what days are you most fertile?

A

Days 8 - 18

36
Q

What are the three criteria that you need to fulfil to make breastfeeding a reliable contraceptive?

A
  1. Only breast feeding
  2. Less that 6 months post natal
  3. Amenorrhoeic
37
Q

What does it mean if a contraception is in category MEC 1?

A

No restriction for use of this contraceptive method

38
Q

What does it mean if a contraception is in category MEC 2?

A

Advantages of using this method generally outweigh the risks

39
Q

What does it mean if a contraception is in category MEC 3?

A

Risks of using this contraceptive generally outweigh the advantages (expert clinical judgement required)

40
Q

What does it mean if a contraception is in category MEC 4?

A

A condition which represents unacceptable risk if the contraceptive method is used.

41
Q

What calculation is used to work out the pearl index for contraception reliability?

A

Number of accidental pregnancies x 1200/ Total months of exposure

42
Q

What is the primary action of the depo provera injection?

A

Inhibits ovulation

43
Q

What condition do you need to consider the risk off before prescribing depo provera?

A

Osteoporosis

44
Q

When can the depo provera injection be given so it will be effective straight away?

A

Up to an including day 5 of the cycle

45
Q

How long do you have to use another method of contraception for if you start the depo provera on day 9?

46
Q

What are the main side effects of the depoprovera injection?

A

Weight gain
Delay in return of fertility
Irregular bleeding
Risk of osteoporosis

47
Q

What is the main mode of action of the IUD?

A

Prevents fertilisation

Inflammatory response in endometrium

48
Q

What is the main mode of action of the IUS?

A

Effect on implantation - endometrium rendered unfavourable for implantation

49
Q

How many days after UPSI can the IUD be fitted for emergency contraception?

50
Q

How many days after a TOP can the IUD be fitted?

A

Immediately (of products of conception seen)

51
Q

How many days after childbirth can the IUD be fitted for emergency contraception?

A

Either within 48 hrs or after 4 weeks

52
Q

How many days after childbirth can the IUS be fitted for emergency contraception?

A

Either within 48 hrs or after 4 weeks

53
Q

How many days after a TOP can the IUS be fitted?

A

Immediately (if products of conception seen)

54
Q

How long is the contraceptive implant licenced for?

55
Q

What is the primary mode of action of the implant?

A

Preventing ovulation

Reproduction (40 decks)

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