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GOSH - LM > Contraception > Flashcards

Contraception Flashcards

1
Q

How effective is the COCP?

A

> 99%

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2
Q

What is the mechanism of action of the COCP?

A

Inhibits ovulation
Increases cervical mucous
Thins endometrial lining

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3
Q

COCP increases the risk of which types of cancer?

A

Breast

Cervical

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4
Q

COCP decreases the risk of which types of cancer?

A

Endometrial

Ovarian

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5
Q

The COCP is effective immediately if started when?

A

Within 5 days of the start of the menstrual cycle

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6
Q

A girl comes in wanting to start the COCP. She is on day 13 of her cycle, what advice would you give her?

A

Start the COCP, however additional contraception (condoms or abstinence) is required for the first 7 days

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7
Q

What are some absolute contraindications of the COCP?

A 
BMI ≥ 40
Migraine with aura
Breastfeeding < 6 week postpartum 
35 years old + smoking ≥ 15 a day
Hx of CVA/IHD/ uncontrolled hypertension
Current breast ca 
Prolonged immobilisation/ recent surgery
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8
Q

What advice would you give someone who has missed a COCP pill at any point in the pack?

A

Take the missed pill as soon as you remember, even if it means taking 2 in 1 day. Take next one as normal - no need for emergency contraception

If 2 missed - take 1 pill immediately and and use condoms for 7 days - further management depends on week of pack

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9
Q

What advice would you give someone who has missed 2 COCP pills in week 1?

A

Will need emergency contraception if she had sex in pill free week or 1st week

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10
Q

What advice would you give someone who has missed 2 COCP pills in week 2?

A

No emergency contraception required, use additional contraception for 7 days

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11
Q

What advice would you give someone who has missed 2 COCP pills in week 3?

A

Omit the pill free week (i.e. back to back next packet)

No contraception required

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12
Q

What drugs can reduce the efficacy of the COCP?

A 
CYP450 inducers - 
Carbamazepine 
Rifampicin
Barbiturates 
Phenytoin 
St John's Wart
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13
Q

What is the mechanism of action of the POP?

A

Thickens cervical mucous

Inhibits ovulation in 50%

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14
Q

What advice about additional protection would you give someone commencing on the POP?

A

If starting within 5 days of starting period, POP effective immediately

If starting at any other point in the cycle, use condoms for 2 days

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15
Q

What are common side effects of the POP?

A

Spotting, particularly in first few months

Weight gain

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16
Q

What are some absolute contraindications to the POP?

A

Pregnant
Breast cancer in last 5 years

Undiagnosed PV bleeding is a relative contraindication

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17
Q

What are the windows for taking the POP?

A

Normal - 3 hours, if ≥ 3 hours take missed pill and use condoms for 2 days

Cerazzete - 12 hour window

18
Q

What are the advantages of the POP compared to the COCP?

A

Lighter or absent periods

Not contraindicated in htn, CVD, migraine

19
Q

What are the E & 6Ps of IUD & IUS?

A

Expulsion - usually within first 3 months
Pregnancy
Perforation
PID
Periods - heavier on IUD, spotting on IUS
Procedure (pain)
Progestognenic side effects (IUS) - acne, weight gain, loss of libido etc

20
Q

What is the mechanism of action of Depo-provera and how often is it taken?

A

Inhibits ovulation –> causes amenorrhea (after initial spotting)
12 weeks

21
Q

The Nexplanon emits how much progesterone daily?

How often must it be changed?

A

~25-70mg

3 years

22
Q

What is the mechanism of action of the IUD?

A

Spermotoxic

Prevents implantation

23
Q

What is the mechanism of action of the IUS?

A

Inhibits ovulation

24
Q

What are the non-contraceptive uses of the IUS?

A

First line treatment of menorrhagia

25
Q

How long is the IUS effective for?

A

5 years

26
Q

IUS & IUD increase the risk of what?

A

PID if inserted whilst woman has an asymptomatic STI

Ectopic pregnancy if the woman becomes pregnant

27
Q

What effect does the IUD have on periods?

A

Heaver & prolonged

28
Q

How often must a women check for the strings of an IUS/IUD?

A

Monthly

29
Q

What contraception is available to all women immediately postpartum?

A

POP

30
Q

When do women require contraception after giving birth?

A

After 21 days (longer if breastfeeding)

31
Q

When can an IUD be inserted postpartum?

A

4 weeks

32
Q

How often is the patch changed?

A

weekly for 3 weeks then patch free week

33
Q

What is the generic name of Levonelle?

A

Levonorgestrel

34
Q

What is the generic name of EllaOne?

A

Ullipristal

35
Q

EllaOne can be taken how long after unprotected intercourse?

A

5 days

36
Q

Levonelle can be taken up to how long after unprotected intercourse?

A

3 days

37
Q

What is the most effective emergency contraceptive?

A

Copper coil

38
Q

When is the copper coil effective as emergency contraception?

A

5 days after intercourse
5 days after expected date of ovulation (if sex occurs 4 days before ovulation IUD can be fitted up to 9 days after intercourse)

39
Q

What should additionally be prescribed for the patient if the copper IUD is used as emergency contraception?

A

Antibiotic prophylaxis

40
Q

Which emergency contraceptive can only be used once per cycle?

A

Ullipristal/ EllaOne

41
Q

How long after being used as emergency contraception can the copper IUD be removed?

A

4 weeks

42
Q

Which emergency contraceptive inhibits the action of some contraceptives?

A

EllaOne/Ullipristal

Inhibits action of progestogens –> barrier contraception required until next period

GOSH - LM (2 decks)

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