Contraception Flashcards
what does the POP do to the female genitals?
thickens cervical mucus
reduces receptivity of the endometrium to implantation
inhibits ovulation
when is the POP effective immediately?
day 1-5 of cycle, if not use condoms for 2 days
what are progesterone side effects?
acne bloating breast tenderness decreased sex drive hirsutism bleeding wt gain mood swings/anxiety/depression
in what conditions can progesterone only contraception not be used?
breast cancer trophoblastic disease liver disease SLE CVD - migraine +aura, stroke, IHD (while on progesterone pill) crohns/malabsorption
what hormone is in the depo injection?
progesterone
when is depo injection given? how long does it last?
first 5 days of cycle, lasts 14 weeks
what age cannot get the depo injection?
> 50yrs
what does the injection increase your risk of?
osteoporosis
what hormone does the implant use?
progesterone
how long does the implant last?
3yrs
when should the implant be inserted?
day 1-5, if not use condoms for 7 days
what are the 3 types of coil and how long do they last?
copper 5-10yrs
mirena 5yrs
jaydess 3yrs
when can copper coil be used as emergency contraception?
120hrs of UPSI or if >5 days since, up to 5 days after ovulation
how do IUDs work?
inhibit implantation
side effect of copper coil?
heavy periods
side effects of jaydess/mirena?
lighter periods
less painful periods
spotting
heavy bleeding
risks with IUD?
expulsion PID dysmenorrhoea menorrhagia ectopic
what does COCP benefit?
decreases ovarian, endometrial and bowel cancer risk
blocks ovarian cyst formation
improves acne
what are oestrogen side effects?
bloating breast swelling/tenderness decreased sex drive fibroids headaches irregular bleeding N+V raised BP wt gain
with oestrogen and progesterone, why may wt gain occur?
oestrogen - water retention
progesterone - increased appetite
who cannot have COCP?
more than 35 years old and smoking more than 15 cigarettes/day migraine with aura thromboembolic disease history of stroke or ischaemic heart disease breast feeding < 6 weeks post-partum uncontrolled hypertension current breast cancer surgery and immobility
what is the most effective emergency contraceptive?
ulipristal acetate (ella one)
how long after UPSI can EllaOne be useD?
120hrs
how does EllaOne work?
inhibits/delays ovulation
when is EllaOne best taken in the cycle?
before LH surge (ideally more than 24hrs)
contraindications for EllaOne?
breast feeding
liver enzyme inducing drugs
drugs reducing gastric pH
when MUST levonorgestrel be given?
before LH surge (day 13)
how long after UPSI can levonorgestrel be given?
72hrs post UPSI
how does levonorgestrel work?
inhibits/delays ovulation
how does lactational amenorrhoea occur?
high PRL levels during pregnancy (not masked by progesterone, once placenta is expelled)
PRL inhibits GnRH which reduces oestrogen
inhibits ovulation
what does IUD pose risk of?
cervical shock
if on OCP, when does a missed pill become dangerous? what must you do?
two or more
continue taking and use protection for 7 days
risks of progesterone only contraceptives?
ovarian cysts
breast cancer
what are stroke risk factors?
smoking obesity age >35yrs DM dyslipidaemia FHx of arterial disease <45yrs
risks of COCP?
breast cancer
cervical cancer
if getting the copper coil, when is it safe to have unprotected safe?
immediately
what must be done before copper coil insertion?
STI screen
if not able to do this, azithromycin
what must patients do to ensure IUD is not expelled?
feel the threads after each period
how many days PP is a women protected for?
28 days
