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Contraception Flashcards

1
Q

Name 3 forms of combined oral contraceptive

A

Oral contraceptive pill
Vaginal ring
Patch

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2
Q

What is the Nuvaring

A

Brand name of combined contraceptive ring

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3
Q

How do you take the oral contraceptive pill

A

On for 21 days
Off for 7 days
Try to take at the same time everyday

Or
Take 3 months continuously then have a pill free week

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4
Q

How do you use the combined vaginal ring

A

Ring inserted for 3 weeks
Then removed for 1 week

Or
3 rings back to back with a break after

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5
Q

Does the vaginal ring interfere with sexual intercourse

A

No

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6
Q

2 Hormones in consumed contraception

A

Oestrogen

Progesterone

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7
Q

How effective is combined oral contraception

A

> 99% when taken correctly

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8
Q

How many days is combined contraceptive effective after

A

7 days

use barrier contraception up until that point

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9
Q

Modes of action of combined contraception

A

Prevent ovulation
Alters FSH and LH (preventing LH surge)
Prevents implantation by thinning endometrial lining
Inhibits sperm penetration of cervical mucous (thickens it)

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10
Q

CI for COCP

A

Migraine with aura
Active liver disease
Current breast cancer

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11
Q

Risks associated with COCP

A

Thromboembolic disease

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12
Q

Advice for missed pills and severe diarrhoea

A

<2hrs take another pill

If delay >48hrs use another form of contraception

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13
Q

Risk factors for thromboembolic disease in COCP users

A 
Major surgery
Immobility 
Thrombophilia 
FH of VTE 
FH>30 
Postnatally 21days 
Cervical risk
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14
Q

Short term oestrogen side effects of combined contraception

A 
Breast tenderness 
Nausea 
Bloating 
Vaginal discharge 
Cyclical weight gain
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15
Q

Progesterone side effects of combined contraception

A 
Mood swings 
PMT 
Vaginal dryness
Sustained weight gain 
Decreased libido 
Acne
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16
Q

Non-contraceptive benefits of combined contraception

A

Improvement acne
Regular bleed
Potential reduction in painful heavy periods
Reduction in functional ovaria cysts
50% reduction in ovarian and endometrial cancer

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17
Q

What is the most popular/common method of contraceptive

A

Combined pill/COCP

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18
Q

Do combined contraceptive methods protect against STIs?

A

No

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19
Q

Forms of barrier contraception

A

Diaphragm
Male condoms
Female condoms

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20
Q

Which is the only form of contraception to protect against STIs

A

Condoms

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21
Q

How to use the diaphragm

A

Need to put spermazide gel on diaphragm and leave in for 6 hours after intercourse

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22
Q

How to take mini pill

A

Same time everyday
within 3hrs period
No pill free interval

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23
Q

How effective is the mini pill

A

> 99% when taken correctly

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24
Q

How many days is the mini pill effective after

A

2 days

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25
Q

Mode of action mini pill

A

Thickens cervical mucous and secretions making it impenetrable to sperm

26
Q

Side effects of mini pill

A 
Menstrual irregularities!!
Increased risk ectopic 
Breast tenderness
Acne 
Decreased libido 
Weight change
27
Q

What is DepoProvera

A

Brand name

Progesterone only injection

28
Q

Dose and route of administration for injection

A

150mg
Deep IM
Upper outer quadrant buttock

29
Q

Usual dose of COCP

A

20-30 microgram EE

30
Q

2nd generation COCP

A

Levonorgestrel

Norethisterone

31
Q

How often do you need to get the injection

A

Every 12 weeks

32
Q

How effective is injection

A

> 99%

If taken correctly

33
Q

Drawbacks of injection

A 
Delay in return to fertility 
No reduction in fertility once returned though 
Reversible decrease n bone density 
Problematic bleeding 
Weight gain
34
Q

Modes of action injection

A

Prevents ovulation
Alters cervical mucous
Prevents implantation

35
Q

Benefits of injection

A

Good for forgetful pill takers
70% women amenorrhoeic
Makes periods lighter
Oestrogen free (good for those at risk of thromboembolic disease or migraine with aura)

36
Q

What new option is under development for the injection

A

S/C self administrating option

37
Q

What is Implant/Nexoplanon

A

Subdermal implant

Brand name

38
Q

Hormones in the implant

A

Progesterone only

39
Q

Describe the makeup of the implant

A

68mg progesterone etonogestrel dispersed in matrix of ethinylvinylacetite (EVA)

40
Q

What is EVA

A

Rate controlling membrane surrounding the pill

41
Q

How is the implant used

A

Inserted into arm by healthcare professional
Into non-dominant arm
3yr use

42
Q

How long do you have the implant in for

43
Q

How effective is the implant

A

> 99% when used correctly

44
Q

Primary action of implant

A

Inhibits ovulation by neg feedback

45
Q

Secondary action of implant

A

Thickens cervical mucous

46
Q

Side effects of implant

A

Irregular bleeding

Amenorrhoea

47
Q

Benefits of implant

A

Good for forgetful pill takers

Does not contain any oestrogen

48
Q

What does the intrauterine device release

49
Q

Mode of action of copper coil

A

Alters cervical mucous
Toxic to sperm
Prevents implantation

50
Q

How long do you keep the IUD in for

A

5-10yrs depending

51
Q

Drawbacks of copper coil

A

Does not protect against STIs

52
Q

What is the intrauterine system

A

T shaped plastic device

Placed into uterus

53
Q

What does the IUS release

A

Progesterone only

54
Q

2 main brands of IUS used in the UK

A

Mirena

Jaydess

55
Q

What is the mirena 1st line Rx of in the UK

A

Menorrhagia

56
Q

3 methods of emergency contraception

A

Copper coil
Levonorgestrel
Ella one

57
Q

How can the copper coil be used as emergency contraception

A

Up to 5 days after unprotected sex

Up to day 19 of menstrual cycle

58
Q

How long can Levongestrel be taken after unprotected sex

A

72hrs after

Morning after pill

59
Q

How long can Ella One be taken after unprotected sex

60
Q

What is the most effective form of emergency contraception

A

Cooper coil

61
Q

has female or male sterilisation got a higher success rate

62
Q

How are males sterilised

A

By permanent division of the vas deferens

Vastectomy

Reproduction (14 decks)

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