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GP > Contraception > Flashcards

Contraception Flashcards

1
Q

What counts as a missed combined pill

A

More than 24 hours since you should have taken it

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2
Q

Advice if missed 1 combined pill

A

Take the missed pill now
It’s fine to take 2 in one day
Take the rest of the pack as normal
Don’t need to use extra contraception

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3
Q

Advice if missed 2+ combined pills

A

Take the last pill you missed now
It’s fine to take 2 in one day
Leave any earlier missed pills
Use extra contraception for the next 7 days
Use emergency contraception if missed 2+ pills in 1st week of a pack and had unprotected sex in the previous 7 days

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4
Q

What to do at the end of the combined pill pack after missing 2+ pills

A

If 7+ pills left after missed pills:
Finish the pack, take the pill free break/placebo pills as normal before starting a new pack

If <7 pills left after missed pills:
Finish pack and start a new pack the next day I.e don’t take the pill free break/placebo pills

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5
Q

What counts as a missed POP

A

More than 3 hours since you should have taken it
OR
More than 12 hours since you should have taken it for desogestrel pills

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6
Q

Advice for missed POP

A

Take last pill you missed now
Take the next pill at the usual time (it’s fine to have 2 in one day)
Take the rest of the pack as normal
Use extra contraception for next 48 hours after taking the last missed pill
Use emergency contraception if you have unprotected sex during the 48 hours after your missed pill

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7
Q

Effectiveness of implant

A

> 99% effective

Up to 3 years

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8
Q

Advantages of implant

A

Useful if can’t use oestrogen contraceptives
Fertility returns very quickly once removed
Safe while breastfeeding
Can help heavy or painful periods

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9
Q

Considerations for implant

A

Can make periods irregular or stop them completely
Can make acne worse
Doesn’t protect against STIs
Small procedure to have fitted and removed with local anaesthetic
Side effects for first few months common e.g nausea, headaches, breast tenderness

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10
Q

When are you protected against becoming pregnant after implant is fitted (include after giving birth)

A

If fitted in first 5 days of menstrual cycle you are immediately protected
If fitted after day 5 of menstrual cycle you need extra contraception for 7 days

If fitted within 21 days after giving birth you are immediately protected
If fitted after 21 days from giving birth you need extra contraception for 7 days

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11
Q

What medications interact with the implant and COCP

A

Treatment for HIV, epilepsy and TB
St Johns Wort
Rifampicin (an antibiotic)

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12
Q

Aftercare for implant fitting

A 
Contact GP if:
Can't feel implant
Implant has changed shape
Pain or skin changes at site of implant
You become pregnant

Advice about extra contraception

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13
Q

Aftercare for IUD

A

May get period type cramps or bleeding for few days after fitting
Need check up appointment in 3-6 weeks

Contact GP if:
Lower abdo pain
High temperature
Odorous vaginal discharge 
Can't feel the threads
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14
Q

How long do the IUD and IUS last for

A

Paragard - 10 years
Mirena - 5 years
Kyleena - 5 years
Jaydess - 3 years

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15
Q

Advantages of IUD

A 
Works straight away
No hormonal side effects
Safe to use in breastfeeding
Fertility returns as soon as IUD removed
Not affected by other medications
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16
Q

Considerations for IUD

A

Doesn’t protect against STIs
Periods may become heavier, longer and more painful
Risk of pelvic infection, displacement, expulsion and womb perforation
Fitting uncomfortable

17
Q

Rules for protection against becoming pregnant if having IUD or IUS fitted after giving birth

A

IUD and IUS can be fitted 4 weeks after giving birth

Need to use alternative contraception from 21 days after giving birth. Use until IUD/IUS is fitted

18
Q

When are you protected against becoming pregnant after IUS is fitted

A

If fitted in first 7 days of menstrual cycle you are protected straight away
If fitted after first 7 days of menstrual cycle you need extra contraception for 7 days afterwards

19
Q

Advantages of IUS

A 
Can help painful or heavy periods
Safe to use when breastfeeding 
Not affected by other medications 
Option if can't have oestrogen contraception 
Fertility returns as soon as IUS removed
20
Q

Considerations for IUS

A

Periods may become irregular or stop altogether
Side effects include nausea, headaches and breast tenderness
Can make acne worse
Doesn’t protect against STIs
Risk of pelvic infection, displacement, expulsion and womb perforation

21
Q

Aftercare for IUS fitting

A

May have period type cramps for few days afterwards
Need check up appointment 3-6 weeks later

Contact GP if:
Lower abdo pain
High temperature
Odorous discharge 
Can't feel threads
22
Q

Instructions for taking first combined pill

A

Monophasic- marked with correct day of week
Phasic - first pill of the first colour
Everyday - marked with start

23
Q

Instructions for using COCP packs

A

Phasic - take pill same time everyday until pack finished. Have 7 days pill free break where you will have a bleed. Start new pack on 8th day, starting on same pill as previous pack

Everyday - take pill same time everyday until pack finished. Start new pack straight away on pill marked start whether you are still bleeding or not.

24
Q

Additional contraception for when starting the COCP

A

Starting within first 5 days:
No additional contraception (get advice if menstrual cycle every 23 days or less)

Starting after day 5:
Additional contraception for 7 days

25
Q

Rules for COCP after giving birth

A

Not breastfeeding:
Start pill on day 21 after giving birth
If start pill after day 21 use additional contraception for next 7 days

Don’t take COCP until 6 weeks after giving birth if breastfeeding

26
Q

Advantages of COCP

A

Can help painful, heavy and irregular periods
Reduced risk of endometrial and ovarian cancer
Reduces acne
Still have periods

27
Q

Disadvantages of COCP

A

Side effects include nausea, headaches and breast tenderness
Doesn’t protect against STIs
Breakthrough bleeding common in first few months
Can raise BP
Increased risk of blood clots and breast cancer

28
Q

Additional contraception for when starting the POP

A

Started within first 5 days of menstrual cycle :
Don’t need additional contraception

Started after day 5:
Need additional contraception until have taken pill for >48 hours

29
Q

Rules for POP after giving birth

A

Start pill on day 21 after giving birth

If start pill after day 21 use additional contraception until you’ve taken the pill for >48 hours

30
Q

Advantages of POP

A

Option if can’t have oestrogen contraception
Can use at any age
Can use if smoker
Safe in breastfeeding

31
Q

Disadvantages of POP

A 
Periods may be irregular or stop altogether
Doesn't protect against STIs
Need to take at same time everyday 
Interacts with other medication 
Increased risk of breast cancer

GP (7 decks)

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