Contraception Flashcards
What are the main types of contraception?
Combined hormonal Progesterone only IUS IUD Barrier methods Natural methods Emergency contraception
Combined hormonal contraception contains which hormones?
Oestrogen and progestogen
What is the main effect of combined hormonal contraception?
Inhibits ovulation
For how long does the contraceptive implant work?
Up to 3 years
What is the main mode of action of the implant?
Inhibits ovulation
What is the main mode of action of the intrauterine system?
Affects implantation - renders endometrium unfavourable for implantation
What is the main mode of action of the intrauterine device?
Prevents fertilisation
What is involved in female sterilisation?
The fallopian tubes are blocked
What is involved in male sterilisation?
The vas deferens is cut
What examinations are done before prescribing LARC?
BMI
Blood pressure
Smear status
PV
Give some indications that a women is not currently pregnant
No sex since last period Consistently using reliable contraception <7 days since last normal period <4 weeks post partum Fully breastfeeding/amenorrhoeic
What are the three methods of emergency contraception?
Copper IUD
LNG-EC (levonelle)
UPA-EC (EllaOne)
When can emergency contraception be used?
Up to 5 days after UPSI
Within 5 days of predicted ovulation
What is the most effective method of emergency contraception?
Copper IUD
How does the copper IUD work?
Toxic to sperm/ovum
Anti-implantation
When can the Cu IUD be inserted?
Up to 120 hours post-UPSI
Up to 5 days after earliest expected date of ovulation
How does oral emergency contraception work?
Delay ovulation by affecting progestogen levels
For how long can LNG-EC be used post-UPSI?
72 hours
For how long can UPA-EC be used post UPSI?
120 hours
UPA is how effective across 5 days?
85%
How does the effectiveness of LNG change?
~85% in first 24hrs
Reduces to approx 58%
LNG works before/during/after LH surge
Before
UPA works before/during/after LH surge
Works during but not after peak
What are the three methods of combined hormonal contraception?
Oral contraceptive pill
Transdermal patch
Vaginal ring
How is the COC taken?
Taken daily for 21 days followed by a 7 day break
Give some factors that may affect effectiveness of CHC
Impaired absorption
Impaired metabolism
Non-compliance
Give some unwanted effects of CHC
VTE Liver enzyme induction Systemic hypertension Arterial disease Increased risk of breast/cervical cancer
Why should CHC not be prescribed in migraine with aura patients?
As it increases the risk of ischaemic stroke
Give some non-contraceptive benefits of CHC
Reduction in ovarian cancer risk
Reduction in acne
When can an IUS be started?
Anytime in cycle if no UPSI in past three weeks
How does the DepoProvera injection work?
Given as an injection every 3 months to supress FSH
