Contraception Flashcards
Which two forms of contraception should be stopped in women of >50 years?
Depo Provera
COCP (lowered dose from ages 40-50)
Which form of contraception is associated with delayed return to fertility?
Depo-Provera
lasts up to twelve weeks and can take several months for the body to return to normal menstruation.
Emergency Contraception: time limit from UPSI and MOA
Levonorgestrel
Ulipristal Acetate
Cu - ICD
Levonorgestrel:
- anovulatory and prevents implantation
- within 72 hours of UPSI
Ulipristal Acetate (progesterone receptor modulator):
- anovulatory
- within 120 hours
Intrauterine Device (Copper):
- inhibits fertilisation and implantation
- within 5 days
First and second line treatment for endometriosis
i) COCP
ii) Progesterone only (POP, implant of injection)
Contraception in the post partum period:
POP
COCP
POP: Any time after birth whether breastfeeding or not. additional contraception after day 21
Side effects of Depo Provera
Depo Provera (medroxyprogesterone acetate) - anovulatory + cervical mucous/ endometrial thickening
i) weight gain
ii) delay of 1 year to fertility
iii) osteoporosis risk
iv) irregular bleeding
Missed pills:
COCP (cerazette)
POP (micronor, noriday, nogeston, femulen)
COCP
- If less than 12 hours late then just take the pill and carry on
- if more than 12 hours late then take the pill and then the next pill at the usual time. (don’t take more than one pill if more than one day was missed)
POP
- if less than 3 hours late then just take the pill and carry on
- if more than 3 hours late then take the pill and then the next pill at the usual time. (don’t take more than one pill if more than one day was missed)
In both instances condoms should be used until 48 hours of regular pill taking has been instated
Lady says she has missed 4 days of POP/COCP pill.
“Shall i just take the 4 pills in one go? Will that be okay?”
No
just take one for the one you missed and then take the next at the regular time.
48 hours of condom cover from when regular pill taking has been resumed
Mode of action:
COCP
Inhibits Ovulation
Mode of action:
POP (Not desogestrel)
Thickens Cervical Mucus
Mode of action:
DOP (deosgestrel)
Inhibits Ovulation
Thickens Cervical Mucus
Mode of action:
Injectable Contraceptive (Medroxyprogesterone acetate)
Inhibits Ovulation
Thickens Cervical Mucus
Lasts for 12-14 weeks
Mode of action:
Implantable Contraceptive (etonogestrel/Nexplanon)
Inhibits Ovulation
Thickens Cervical Mucus
-Lasts 3 years
-Immediate contraceptive before on the fourth day of menstrual cycle
-
Mode of action:
IUCD (Long term and emergency)
Long Term Contraception:
Decreases sperm motility and survival
Emergency:
Toxicity to sperm and ovum
Inhibits implantation
Mode of action:
IUS (levonorgestrel)
Prevents endometrial proliferation
Thickens cervical mucus
