contraception Flashcards
what are the fraser guidelines (gillick competence)
what are the fraser guidelines (gillick competence)
how do the contraceptives work- progestogen
further suppresses LH release, alters quality of cervical mucus, endometrial changes
how do the contraceptives work- progestogen
further suppresses LH release, alters quality of cervical mucus, endometrial changes
what are the 2 types of COC
monophasic and triphasic
what is monophasic COC
amount of oestrogen and progestogen the same in each tablet
what is triphasic COC
varying doses of both- less progestogen and more oestrogen
cautions COC
hyperprolactinaemia, BRCA gene carrier, venous and arterial risk factors
cautions COC
hyperprolactinaemia, BRCA gene carrier, venous and arterial risk factors
absolute CI to COC
migraine with aura, migraine without aura with >1 risk factor stroke, severe migraine or migraine >72h, migraine treated with ergot derivatives
drugs interfering with COC
liver enzyme inducers- anticonvulsants, st johns wort, rifampicin
benefits COC
menstrual disorders reduced, pelvic infection reduced, benign breast disease reduced, functional ovarian cysts endometriosis and fibroids reduced; endometrial and ovarian cancers reduced
disadvantages COC
arterial and venous disease, thromboprophylaxis if taking 4 weeks before surgery, incr risk cervical cancer
side effects COC
acne, breakthrough bleeding, headaches, mood changes, N&V, vaginal discharge, weight gain
what effect does progestogen only pill have
makes cervical mucus hostile to sperm
which oral contraceptive should be taken if breastfeeding
POP
what is the depot progestogen
the injection
CI injection
pregnancy, breast cancer, undiagnosed vaginal bleeding, liver/cardiac disease
CI injection
pregnancy, breast cancer, undiagnosed vaginal bleeding, liver/cardiac disease
advantages of the injection
secret, no oestrogen content, ok if breastfeeding, protects against ectopics, fewer cysts, less endometriosis
problems with the injection
irregular menstrual bleeding
what does the implant contain
progesterone- ethonogestrel
how long does the implant last
3 years
function of the implant
inhibit ovulation, thicken mucus
what do the patches contain
oestrogen and progesterone
side effects patches
breast discomfort and breakthrough bleeding
how does the vaginal ring work
soft ring containing oestrogen and progesterone fits in upper vagina around the cervix mimics COC
advantages of vaginal ring
under the womans control- can decide whether to have a withdrawal bleed. change every cycle
side effects vaginal ring
can be expelled from the vagina, irregular bleeding
how does the IUCD work
prevents implantation
advantages of the IUCD
highly effective. rapid return to fertility after its removal
advantages of the IUCD
highly effective. rapid return to fertility after its removal
problems with IUCDs
expelled by uterus if nulliparous/distorted uterus, heavy painful periods, infection and subfertility, during insertion can get perforation of the uterine wall
contraindications IUCD
pregnancy, current infection, ovarian cancer, endometrium or cervix, distorted uterine cavity, Hx ectopics, abnormal bleeding
what should you screen for before insertion IUCD
STDs or give prophylactic abs
if become pregnant on the IUCD what should be done
remove as can lead to miscarriage
if there are lost threads in IUCD what to do
ultrasound
if there is an infection on IUCD what to do
treat with device in place, if remove don’t reinsert for 3 months
before removal IUCD what needs to happen
start alternative contraception
IUS what is the drug
levonorgestrel
what happens in vasectomy
ligate and excise vas deferens
what is there a risk of after vasectomy
chronic testicular pain
how long does it take for sperm stores to be used up after vasectomy
3 months
within what time frame can vasectomy be reversed
10 years
within what time frame can vasectomy be reversed
10 years
up to how long can you insert IUCD for emergency contraception
120 hours (5 days)
what pill is used as emergency contraception
levonorgestrel
within how many hours of unprotected sex can levonogestrel be given
72hours
if vomiting within 2 hours of taking emergency pill what should you do
take another immediately
