Contraception Flashcards
COCP - Side effects
Nausea
Breast pain
Headache
Initial irregular bleeding
COCP - Benefits
- Decrease in ovarian cysts and benign breast disease
- Decreased risk inside Ca - Ovarian and endometrial
- Control of bleeding
COCP - Risks
- VTE, stroke, MI (smoker)
- Ca breast and cervix
cOcp increase risk of Outside cancers
UK MEC 4 - COCP
- smoking >15 day >35 years
- BP <160/95
- Migraine with aura
- CVA
- Breast Ca
- Liver disease
Starting COCP
Day 1-5 effective immediately
> 5 = condoms and abstain for 1 week
Missed Pill
Take pill as soon as remember, even if taking 2 pills in one day
2 or more pills (use condoms for 7 days)
- 1st week: need EC
- 2nd week: continue as normal
- 3rd week: run next pack back to back
POP - Side effects
- Irregular bleeding
- Mood changes
- Weight gain
- Headaches
- Acne
POP - UK MEC 4
Breast Ca in last 5 years
CVA
Cirrhosis/hepatoma
P450 inducer use (decrease effectivity of POP)
Starting POP
Day 1-5 effective immediatly
> 5 extra precautions for 2 days
POP - Missed Pill
Cerazette - 12 hour window
Missed pill = extra precautions for 48 hours
Implant
- SE
- F rate
- Drug Interactions
3 years
- irregular bleeding
- 0.05% failure
- Enzyme inducer interaction
IUS
- SE
- F rate
- Drug Interactions
5 years
- lighter, irregular bleeding
<1% over 5 years
Depo
- SE
- F rate
- Drug Interactions
12 weekly
- 3 kg weight gain in 2 years
- 6-12 month fertility delay
- 0.4% failure rate
Very good for HIV/Epilepsy as no interactions
Starting a LARC
Day 1-5: effective immediately
> 5 = condoms for 7 days
IUS/IUD - before fitting
On period/no sex since period
Other reliable method (not condoms)
No sex in last 3 weeks and negative PT
- Negative STI screen
IUS - E and 6 P’s
- Expulsion (1 in 20, first 3 months)
- Procedure ( Pain when fitting)
- Progestogenic side effects
- Periods (irregular bleeding)
- Pregnancy (FR and ectopic risk)
- PID (increased risk only first 3 weeks)
- Perforations (1 in 1000, immediate or over time)
IUD/IUS UK MEC 4
- Pregnancy
- Undiagnosed bleeding
- Cervical/uterine Ca pre treatment
- Active PID in previous 3 months
- Current chlamydia/gonorrhoea
- Gestational trophoblastic disease
MEC 3
- Uterine abnormality
- Long QT
Emergency Contraception - Pill
Levonelle 1500mcg
- 3 days, delays ovulation
Ella One (Ullipristal 30mg)
- 5 days, delays ovulation
- Not effective >1 in same cycle
- Not in asthmatics
Emergency Contraception - Pill Side Effects
- N&V
- Breast tenderness
- Bleed after you take it
- Menstrual disturbance (delayed more than 7 days, contact GP)
- Dizziness, headache, tiredness
Emergency IUD
5 Days
- Must exclude pregnancy/STIs
- If patient has ovulated in previous 5 days - USE IT!
- Good for mid cycle
Termination - Medical
Mifepristone and Misoprostol
<9 weeks
Termination - Surgical
Manual vaccuum aspiration 9-12 weeks
Surgical Evac 7-15 weeks (GA)
