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Repro HK > contraception > Flashcards

contraception Flashcards

1
Q

general side effects of hormonal contraception

A 
headache 
weight gain
bloating 
breast tenderness 
loss of libido
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2
Q

side effects of progesterone contraception

A 
acne 
mood changes 
hirsutism
vaginal dryness
like a moody teenager
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3
Q

side effects of oestrogen contraception

A

fibroids
nausea/vomiting
hypertension
vaginal discharge

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4
Q

what are the 2 broad categories of contraception

A

LARC

non-LARC

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5
Q

hormones in combines oral contraceptive pill

A

oestrogen and progesterone = ethinylestradiol

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6
Q

mode of action of COCP

A

inhibits ovulation

decreased endometrial thickening

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7
Q

when should COCP be started? what should you do if this is not possible?

A

days 1-5 of cycle

use condoms for 7 days if unable to do so

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8
Q

benefits of COCP

A

protective against ovarian and endometrial cancers

good for acne

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9
Q

risks with COCP

A

thromboembolic disease

breast and cervical cancer

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10
Q

when is COCP contra-indicated

A 
current breast cancer 
post-partum <6 weeks and breast feeding 
migraine with aura
cardiac history
immobile 
>50 years
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11
Q

when should break through bleeding stop on COCP and what should you investigate if persists

A 
should stop >3months
check compliance 
rule out chronic vomiting/diarrhoea 
STI screen 
smear
pregnancy?
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12
Q

mode of action of progesterone only pill

A

inhibits ovulation
slows fallopian tube transport (decreases action of cilia)
decreases endometrial thickening
thickens cervical mucous

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13
Q

most common POPs

A

levongestrel, norethisterone, desogestrel

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14
Q

when should POPs be started and what should you recommend if unable to do so

A

days 1-5 of cycle

use condoms for 2 days after starting

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15
Q

when is POP contraindicated

A 
breast cancer 
trophoblastic disease (molar pregnancy)
SLE
liver disease (interacts with liver enzyme drugs)
malabsorption
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16
Q

patient is on POP and has new onset migraine with aura/MI/stroke/TIA

A

stop medication

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17
Q

POP can/cannot be continued after 50 years

A

can be continued

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18
Q

missed pill rules for COCP

A

1 missed - take as soon as realise. take next pill as normal
2 missed - take next one as normal. condoms until 7 days consecutive pill

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19
Q

missed pill rules for POP

A

1 missed - if > 3 hours, use condoms for 48 hours (unless devogesterel - if more than 12 hours)

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20
Q

what should patients be warned about timings of POPs

A

very narrow window - should be taken at same time every day

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21
Q

what is depoprovera and what hormone does it use

A

injection

progesterone

22
Q

how often should depo be given vs how long does it last

A

given every 12-13 weeks

lasts 14 weeks

23
Q

when should depo be given and what should you do if unable to do so

A

days 1-5 of cycle

7 days condoms if cant

24
Q

advantages of depo

A

helps PMS and menorrhagia

25
Q

what effect does depo have on fertility

A

delay in return of fertility after stop depo

26
Q

when is depo contraindicated

A

> 50 years
risk of osteoporosis
same risk factors for POP

27
Q

what hormone does implant use

A

progesterone

28
Q

how long does implant last

A

3 years

29
Q

implant can/cannot be continued after 50 years

A

can be continued

30
Q

why might effectiveness of implant decrease in third year

A

if obese (>35 years) - should change implant early

31
Q

when should implant be inserted and what to do if unable to do so

A

days 1-5 of cycle

7 days condoms if cannot

32
Q

benefits of implant vs depo

A

no osteoporosis risk

immediate return of fertility

33
Q

side effect of implant

A

amenorrhoea with infrequent bleeding

34
Q

what hormone does IUS have

A

progesterone

35
Q

what are the 2 types of IUS and how long do they last

A

mirena - 5 years

jaydess - 3 years

36
Q

mode of action of IUS

A

prevents implantation
prevents endometrial thickening
thickens cervical mucous

37
Q

when should IUS be inserted and what to do if cant

A

days 1-5 of cycle

7 days condoms if not

38
Q

benefits of IUS compared to IUD

A

less risk of PID and ectopic pregnancy

lighter, less painful periods

39
Q

special circumstances IUS is good for

A 
breastfeeding 
obesity 
CVD
liver enzyme drugs 
endometriosis
40
Q

SE of IUS

A

spotting for first few weeks

intermestrual bleeding

41
Q

mode of action of copper coil

A

copper is a spermicide

inflammatory response in endometrium - no implantation

42
Q

how soon are you protected after insertion of copper coil

A

immediately

43
Q

SE of IUD

A

expelled
heavier, more painful periods
cervical shock

44
Q

what should be checked before insertion of IUD

A

STI check

45
Q

what should be checked after each period

A

threads

46
Q

what is used for emergency contraception

A

copper coil
ella-one (ullipristal acetate)
levonorgestrel

47
Q

what is the most effective emergency contraception

A

copper coil

48
Q

if unable to screen for chlamydia before emergency insertion of copper coil - what should be given

A

azithromycin

49
Q

what emergency pill can be given if <120hours since sex

A

ullipristal acetate

50
Q

how long after sex can you give levonorgestrel

A

up to 72 hours

51
Q

contraindications of ullipristal acetate

A

breast feeding
liver enzyme enducing drugs
gastric pH lowering drugs
severe asthma

Repro HK (37 decks)

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