Contraception Flashcards
Mechanism of action of COCP
Stops ovulation and increase cervical mucus production.
Thins the endothelial lining too.
Can regulate periods and improve achne
How to take the COCP
Every day for 3 weeks
Then one week off
ideally start on day on cycle or use condom for first 7 days
Advice over missed COCP
Use the advice on the packaging
More than one, would say not covered and use barrier contraception
Take around the same time every day
SE of COCP
Headaches Nausea Mood changes Breast tenderness These often resolve
Contrindications to COCP
Migraine with aura
VTE hx
Smoke 35+
Breast feeding
Action of progesterone only pill
Increases thickness of cervical mucus and thins endothelium
How to take progesterone only pill
Take same time each day
Every day
Ideally start on day 1 of cycle or use barrier for 7 days
Missed progesterone pill
Take straight away
>3 hrs use condom for 2 days
Consider emergency contraception of had sex 2-3 days before or after missed pill
What does progesterone pill do to periods?
Can make lighter or even stop them.
SE of progesterone only pill
Mood swings
Acne
Headache
Tender breasts
Contraindications to progesterone only pill
Breast cancer
Undiagnosed PV bleed
Liver disease
Mechanism of action of progesterone depo injection
Stops ovulation
Increased cervical mucus / thickens mucus
Thins endothelium
How often is the depo injection given
every 3 m
Hormonal SE for progesterone injection
Mood swings weight gain acne headache tender breasts periods can be irregular
contraindications for progesterone injection
cancer
liver disease
undiagnosed PV bleed
How long can it take for fertility to return after progesterone injection stopped ?
18m
Progesterone implant MOA
Stops ovulation
increased cervical mucus
thins endothelium
How is the implant put in?
inserted under the skin
local anaesthetic
bleeding / bruising / infection / scarring
SE of progesterone implant
mood swings weight gain acne headache tender breasts
red flag after implant put in
red and sore arm
discharge
systemically unwell
Mirena coil mechanism of action
progesterone
stops ovulation
increase cervical mucus
thins endothelium
what needs to be checked before coil put in ?
STI check
When are they covered by the coil straight away?
first 7 days of cycle
if not - condom for first 7 days
How long does the mirena coil last for
3 - 5 years
what happens to periods on mirena coil
lighter
shorter
less painful
often get irregular bleeding or spotting
how often check strings with the coil?
every 4 weeks
red flags after coil insertion?
severe pain
smelly discharge
high temp
Contraindications to the coil
PID <3m ago STI gynae cancer small uterine cavity undiagnosed PV bleed
mechanism of action of the copper coil
spemicide
and alters cervical mucus
when does the copper coil start working?
straight away
how long can the copper coil work for?
10 years
coil impact on periods
can make heavier or more painful
up to how long after sex can the levongestrel pill be used?
72 hrs
up to how long after ellaone pill after sex?
120 hrs
when cannot use ellaone if ?
previously used in a cycle
impact of ellaone on starting contraception
may reduce efficacy
emergency contraception q.
Sexual history – when? Who? Check consensual, is it a regular partner Current contraception Type Reason for failure Why they need emergency contraception LMP Cycle length Current day of cycle PMH: HTN, migraine with aura FH: VTE, stroke, migraine with aura SH: smoking, drinking Any possibility they could already be pregnant/ used emergency contraception in this cycle Symptoms of STI – vaginal discharge, bleeding, warts Smears up to date Future contraception options Risk of STIs Advice to take pregnancy test in 3 weeks Safety net for ectopic PMH
MEDICATION
If start pill on day one of cycle -
If not….
Don’t need barrier contraception
Need BC for 7 days
medication in ellaone
ulliprestel
copper coil mechanism of action in emergency
prevents implantation
up to how long after sex can copper coil be put in?
5 days
which emergency contraception not affected by hormonal contraception
levongestrel and copper coil
how long do eggs last?
one day
how long do sperm last?
5 days
Which medication reduces efficacy of ellaone
PPI and ranitidine
Within what time frame, if they vomit should they take the emergency pill?
2 hrs
