Contraception Flashcards
Modes of contraceptive action:
Combined oral contraceptives
Inhibition of ovulation
Antibiotics which might interfere with effect of CHC
Liver enzyme inducers e.g. rifampicin
Missed pill advice for CHC:
a) one pill missed
b) two pills missed
a) take missed pill as soon as remembered and rest as normal
b) take last pill and continue taking as normal; EC may be needed
When is EC needed for two missed pills with the CHC?
Days 1-7.
What advice is given for two missed CHC pills in days 15-21?
Finish pills in current pack and omit pill-free interval
Absolute contraindications to CHC (4)
Migraine with aura
Age over 35, smoking >15 a day
Current breast cancer
Stroke/TIA/VTE
Modes of contraceptive action:
Progesterone only pill (2)
Thickening cervical mucus; desogestrel also inhibits ovulation
If POP is started on a day other than days 1-5 of cycle,how many days additional precaution should be used?
2
How are periods affected by the POP?
Irregular bleeding
Modes of contraceptive action:
Copper IUD (2)
Prevents implantation; toxic to sperm
Problems associated with IUCD (3)
Heavy menstrual bleeding
Uterine perforation
Expulsion risk
Modes of contraceptive action:
Progesterone implant (2)
Prevents ovulation, thickens cervical mucus
Problems with nexplanon (5)
Irregular/heavy bleeding Headache Nausea Breast pain Weight gain
How long does nexplanon last?
3 years
Modes of contraceptive action:
Progesterone injection/Depo Provera (3)
Stops ovulation
Thickens mucus
Thins endometrium
How often is depo-provera given?
Every 12 weeks
Adverse effects of depo-provera? (5)
Not quickly reversible Delay in fertility return Irregular bleeding Weight gain May increase osteoporosis risk
Risks of the Mirena coil?
Infection, expulsion, perforation
When is contraception required post-partum for non breastfeeding women?
Day 21
Three methods of emergency contraception; when can they be used?
Levonellle (72hrs)
ellaOne (120 hours)
Cu-IUD- 120 hours, or 120 hours after earliest expected date of ovulation
Factors used to assess STI risk (3)
Women under age 25
New sexual partner
More than one sexual partner in last year
Important aspects of an emergency contraception consultation (4)
History of LSI Menstrual and gynaeocological history General medical history Consider STI risk/testing Also consider future contraceptive needs
What is the active agent in a) levonelle and b) ellaOne?
a) levonergestrel
b) ulipristal acetate, a selective progesterone receptor modulator
Why should an IUD ideally be inserted early in the menstrual cycle (i.e. soon after period begins)?
Procedure is easier through the soft and dilated cervix, and pregnancy is ruled out
A history of pelvic inflammatory disease within what time period is a contraindication to insertion of an IUD?
3 months
Modes of contraceptive action:
Mirena IUS (2)
Thickens cervical mucus
Thins endometrium
