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Y3 Reproductive > Contraception > Flashcards

Contraception Flashcards

1
Q

Give examples of combined hormonal contraception

A

Combined pill COC
Patch CTP
Vaginal ring CVR

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2
Q

Give examples of progesterone only contraception

A

Progesterone only pill POP
Implant
Depot
Intra-uterine system IUS

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3
Q

Give examples of non-hormonal contraception

A

Copper coil
Sterilisation
Barrier contraception
Cyproterone acetate

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4
Q

What method of contraception is being described “blocks sperm getting to genital tract”?

A

Barrier contraception

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5
Q

What method of contraception is being described “blocks the fallopian tubes”

A

Female sterilisation

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6
Q

What method of contraception is being described “the only type of contraception that protects against STIs”?

A

Condoms

barrier contraception

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7
Q

What method of contraception is being described “has the lowest failure rate of all contraception methods”?

A

Implant

progesterone only

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8
Q

What method of contraception is being described “this method of combined hormonal contraception is least likely to cause acne, intermenstrual bleeding and mood changes”?

A

Vaginal ring CVR

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9
Q

What method of contraception is being described “this method only requires 1 dose every 13 weeks”?

A

Depot

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10
Q

What method of contraception is being described “this method of contraception is contraindicated in migraine with aura”

A

Combined pill COC

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11
Q

Why is COC contraindicated in migraine with aura?

A

Increases stroke risk

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12
Q

What method of contraception is being described “this method is less effective in patients who weigh over 90kg”?

A

Combined transdermal patch

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13
Q

Which methods of contraception is being described “this method inhibits ovulation and has an effect on cervical mucus, the endometrium and fallopian tube transport”?

A

Progesterone only: POP, implant, depot

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14
Q

What method of contraception is being described “this method can be start anytime in the menstrual cycle if the patient has had no unprotected sex in the past 3 weeks”?

A

Intra-uterine system IUS

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15
Q

When prescribing the IUS, why must you wait until 3 weeks after unprotected sex before initiating?

A

Risk miscarrying potential ongoing pregnancy

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16
Q

What does LARC stand for?

A

Long acting reversible contraception

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17
Q

What method of contraception is being described “contraception is not its primary indication but it has an indirect contraceptive effect”?

A

Cyptoterone acetate

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18
Q

Name methods of LARC

A

Intra-uterine system
Implant
Depot IJ

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19
Q

What hormones are in combined hormonal contraception?

A

Estrogen + progesterone

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20
Q

What is the method of CHC?

A

-Ve feedback on GnRH
Decreases LH/FSH
Inhibits ovulation

(No folliculogenesis, exogenous estrogen still causes endometrial proliferation hence withdrawal bleeding)

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21
Q

Weight gain is a side effect of combined hormonal contraception. T or F

A

False, no evidence, though estrogen does increase appetite

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22
Q

What are the side effects of combined hormonal contraception?

A 
Venous/arterial thrombosis
Increased BP
Mood
>Stroke/MI risk
Mood
Acne
Intermenstrual bleeding
Tender breasts
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23
Q

What is the dosing regimen for the combined pill?

A

21 days on, 7 days off (withdrawal bleed)

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24
Q

When should you initiate the combined pill?

A

On the 1st 5 days of your period
OR
Any time if definitely not pregnant + 7 days condoms

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25
Q

By what mechanism does combined hormonal contraception have an effect on metabolism?

A

Induce P450 liver enzymes

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26
Q

What is the dosing regimen for the combined transdermal patch?

A

Lasts 1 wk

3 wk on, 1 wk off

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27
Q

How long does the combined vaginal ring last?

A

3 wk on, 1 wk off

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28
Q

By what mechanism does combined hormonal contraception increase risk of venous and arterial thrombosis?

A

Estrogen decreases antithrombin III and has effects on protein S

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29
Q

For which methods of combined hormonal contraception should you monitor blood pressure?

A

All 3 of them

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30
Q

How often should you check blood pressure with combined hormonal contraception?

A

Once after 1st 3 months, annually from then on

31
Q

What are the contraindications to all types of combined hormonal contraception?

A

BP >140/90
<6wk postpartum
PMH/ genetic FH breast cancer

32
Q

Why is combined hormonal contraception contraindicated in patients <6wk postpartum?

A

Increased VTE risk

33
Q

What is the name of the progesterone only pill?

A

Desogestrel

34
Q

Does the progesterone only pill effect liver metabolism PY450?

A

No

35
Q

When should you initiate progesterone only contraception?

A

On 1st 5 days of period day
OR
Anytime if certain not pregnant + 2 days condoms

36
Q

Intermenstrual bleeding as a side effect of combined hormonal contraception usually settles within what time frame?

A

First 3 months

37
Q

What is the name of the drug in the depot IJ?

A

DMPA

38
Q

Where should the depot injection be injected?

A

Subcutaneously

39
Q

What are the contraindications to progesterone only contraception?

A

Osteopenia, breast cancer

40
Q

How long does the intrauterine system last?

A

Mirena and Kyleena 5yr

Jaydess 3yr

41
Q

When should the intra-uterine system IUS be initiated?

A

Anytime in cycle if no unprotected sex UPSI past 3wk

42
Q

Does the intra-uterine system effect liver metabolism PY450?

A

Yes

43
Q

Which method of contraception prevents fertilisation?

A

Copper coil IUD

also cause an inflammatory response in the uterus

44
Q

How long does the copper coil IUD last?

A

5 years

45
Q

What is the name of the copper coil IUD?

A

No brand name

46
Q

What are the direct indications for cyproterone acetate?

A

Acne/hirsutism

47
Q

What must you be careful of when deciding when to perform female sterilisation?

A

Must have 0 pregnancy risk at time; causes ectopic
Make sure not to cut the ureter

(Ureter vermiculates, water under the bridge)

48
Q

When should the copper coil IUD be inserted?

A

Anytime if no UPSI 3wk
OR
Emergency contraception

49
Q

When in the menstrual cycle is the copper coil IUD effective as emergency contraception

A

5 days after likely ovulation

(Would potentially be effective 5 days prior but that would technically be causing a miscarriage so isn’t licensed)
(Can also be inserted if unprotected sex less than 5 days go and ovulation more than 5 days ago since 0 pregnancy risk so no miscarriage risk)

50
Q

What is the most effective method of emergency contraception?

A

Copper coil IUD

should be offered to everyone requesting emergency contraception

51
Q

Having the combined patch or ring out/off for longer than ____ is an indication for emergency contraception

A

48hours

52
Q

In someone who isn’t breastfeeding, how long postpartum can you say it is reasonably certain they’re not pregnant?

A

Less than 4 weeks

53
Q

How many days since someone’s last period can it be for you to say it is reasonably certain they’re not pregnant?

A

Less than 7 days

54
Q

What are the names of the oral methods of emergency contraceptions

A

LNG (levonorgestrel)

UPA (ulipristal acetate)

55
Q

How long post UPSI is the oral emergency contraception effective?

A

LNG 3 day

UPA 5 day

56
Q

What is the method of emergency contraception LNG?

A

Progestogen: delays LH surge; delays ovulation

57
Q

When is LNG emergency contraception not effective?

A

2 day post ovulation

58
Q

When should you double dose LNG emergency contraception?

A

BMI >26

59
Q

What is the method of emergency contraception UPA?

A

Anti-progestogen delay ovulation

60
Q

When is emergency contraception UPA contraindicated?

A

Severe asthma

Breastfeeding

61
Q

When is UPA emergency contraception not effective?

A

2day post ovulation

Taken POP/CHC in past 7 days

62
Q

What days of the menstrual cycle are you most fertile?

A

8-18

63
Q

What are the criteria for lactational amenorrhea

A

Exclusively breastfeeding
<6/12 postnatal
Amenorrhea

64
Q

How can cervical mucus be monitored for fertility?

A

Thick sticky for 3day after ovulation

No mucus 0-5 days, from 5 to 14 days gets progressively less sticky, from 14-28 days sticky

65
Q

When monitoring basal body temperature (before rising in the morning) what change indicates you are more fertile?

A

Temp >0.2 for 3 days after 6 days of

66
Q

What position is the cervix in when fertile?

A

High in vagina, soft, open

67
Q

Nexplanon is the brand name for which type of contraception?

A

Subdermal implant

68
Q

Name 3 brand names of the COC

A

Rigevidon, microgynon, yasmin

69
Q

The IUS is good for dysmenorrhea. T or F

A

True

70
Q

What method of contraception is spermicidal?

A

Copper coil

Also causes local inflammatory response and kills blastocysts pre-implantation

71
Q

How long is it until the IUD copper coil is effective?

A

Immediately

72
Q

How long is it until the IUS is effective?

A

After 7 days

Except 1st 7 days of menstrual cycle when infertile anyway

73
Q

What are absolute contraindications to the IUS and IUD?

A

Uterine abnormality eg. huge fibroids

Pregnant

Y3 Reproductive (28 decks)

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