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GASH > Contraception > Flashcards

Contraception Flashcards

1
Q

Contraceptive implant

A

Etongesrel (progesterone) 25-70mg daily
Duration = 3 years
Removal is easy - rapid resumption of fertility

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2
Q

Side effects of contraceptive implant?

A

Irregular bleeding (12%) - improves with time

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3
Q

Injection depo-provera

A

Deep Im injection - 150mg

duration = 12 weeks

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4
Q

Side effects of contraceptive injection?

A

Irregular bleeding in first few weeks - usually followed by amenorrhoea
Amenorrhoea is prolonged after discontinuation (may take 6 months to resume fertility)

Reduced bone density after 2-3 years, recovers after discontinuation (Nb. avoid in those at risk of OA)

Weight gain (2-3kg in a year)

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5
Q

Advantages of injection?

A

Improves PMS

Effective in treatment for heavy, painful periods

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6
Q

Copper IUD

A

Copper = spermatoxic and prevented implantation
10 years
V. effective

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7
Q

Disadvantages of IUD

A

Pain/cervical shock can occur
Presence of asymptomatic STI can cause PID
Heavier and more painful periods can occur
Perforation –> migration into abdominal cavity

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8
Q

Advantages of IUD?

A

Can be inserted >4 weeks after birth
48 hours after TOP
Can be used as emergency contraception if inserted 5 days after ovulation

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9
Q

Mirena IUS

A

Levonorgestrel (20mcg daily over 5 years)
Pearl index = <0.2
thickens cervical mucus, thins endometrial lining, inhibits sperm survival
DOESN’T STOP OVULATION

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10
Q

Disadvantages of Mirena IUS?

A

Pain/cervical shock
Irregular periods
PID risk with presence of STI
Perforation risk

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11
Q

Advantages of mirena?

A

Can be used to treat menorrhagia

Local release of hormone prevents systemic effects

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12
Q

E and 6 P’s for concealing for IUD/IUS?

A

Expulsion

Pregnancy (rate failure and ectopic)
Periods
Perforation
PID
Procedure (pain)
Progesterone side effects - acne, weight gain, loss of libido, vaginal dryness, breast tenderness
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13
Q

Mode of action of COCP?

A

Synthetic oestrogen and progestogen prevent release of FSH and LH (prevent ovulation)
Thicken cervical mucus
Thins endometrium

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14
Q

Monthly schedule for COCP?

A

21 days on

7 days off - allows withdrawal bleed

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15
Q

Pearl index of COCP?

A

~1%

V. dependent on user effectiveness

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16
Q

Advantages of COCP?

A

Leads to regular, lighter and less painful periods (used to treat menorrhagia and dysmenorrhoea)
Can reduce acne, ovarian cysts and benign breast disease
Can be protective against PID (but still use condoms for casual sex!)
Protective against endometrial, ovarian and colorectal cancer
Contraceptive effects reversible upon stopping

17
Q

Disadvantages of COCP?

A

Heavily reliant on correct use
Increased risk of VTE, stroke and IHD
Offers no protection against STIs

18
Q

Side effects of COCP?

A

Temporary (<3months)

Headache, nausea and breast tenderness

19
Q

Drug interactions of COCP?

A

CYP450 inducers reduce efficacy of COCP

Carbemazepine, phenytoin, rifampicin, barbiturates, st johgns wort

20
Q

Absolute CI for COCP?

A 
CVD:
Hx of VTE
Hx of cerebrovascular accident
Severe hypertension
Inherited thrombophilia
Pregnancy
Dm with vascular problems
Active chronic liver disease

Head: Migraine with aura

Cancer: Breast/endometrial

BMI> 40

Smokers >35 who have been smoking for >15 cigs a day

21
Q

Relative CI of COCP?

A 
BMI 35-40
Age>40
Smokers <35yrs
Chronic inflammatory disease
Renal impairment, DM
Breast feeding (<6 months)
22
Q

When is there no need for barrier contraception when starting the COCP?

A

If they start taking the pill in the first 5 days of menstruation

If started at another time must use condoms for 7 days

23
Q

Method of action of POP?

A

Thickens cervical mucus and thins endometrial lining

Usually causes amenorrhoea

24
Q

Use of POP

A

Started within first 5 days - immediate proptection

Started >5 days - use barrier contraception for 2 days

25
Q

Window of POP

A

Higher dose - 12 hour window
Lower dose - 3 hour window

(COCP has 24hr window)

26
Q

Advantages of POP

A

Can be used in most people with CI to COCP
Usually causes amenorrhoea
Can be used immediately postpartum and breastfeeding

27
Q

Disadvantages of POP

A

Not as effective as COCP
Increased risk of ovarian cysts and ectopic pregnancy
Irregular bleeding initially

28
Q

When should barrier contraception be used when taking the COCP?

A

If missed >= 2 pills
If starting >5 days into cycle
If they did not restart taking pill after placebos at correct time (i.e. more than 7 days not taking pill)

Use condoms for 7 days

GASH (13 decks)

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