Contraception Flashcards
How many pregnancies are unplanned?
1 in 3
How many days can sperm survive in the vagina?
5 days
What does the CHC contain?
Oestrogen and progesterone
How does the CHC work?
It inhibits ovulation
How many days does it take for the COCP to be effective?
7 days
TRUE/FALSE
You need one patch per cycle
FALSE
Normally need about 3
Benefits of the combined hormonal vaginal ring
Less bleeding problems, acne, irritability/mood changes
Desogestrol good for…
Acne
Headache
Breakthrough Bleeding
What 3 things affect the effectiveness of CHC?
Impaired absorption
Increased metabolism
Forgetting to take it
What are the risks with CHC?
VTE Arterial thrombosis Cancer- breast and cervical Blood clotting Systemic hypertension MI Liver
Side benefits of CHC?
Cancer-endometrial and ovarian
Improvement in acne
Decreased menorrhagia/dysmenorrhoea
decreased menopausal symtpoms
Absolute CI to CHC
Migraine with aura
Migraine w/o aura but 1+ RF for stroke
Severe Migraine or migraine treated with ergot derivatives
What is an extra specific CI for COCP?
Women >40 with a high BMI
How is CHC taken?
-Start in 1st 5 days of mensuration (or any time if sure not pregnant + condoms for 7 days)
What are the short term SE of CHC?
Breast tenderness Nausea Wt gain Mood swings Usually resolve within 2-3 cycles
When should you stop taking the pill?
If chest pain or breathlessness, leg swelling/pain, severe stomach pain, unusual long headache or BP increase
After what period of time of forgetting the pill should you use condoms?
if >48h since pill use condom for 7 days
TRUE/FALSE
If you vomit <2h after taking a pill then you should take another
true
How many days postpartum can you start CHC if not breastfeeding?
21 days
How many weeks postpartum can a IUCD be fitted?
4 weeks
If there is a TOP <24wks gestation how soon can CHC be started?
5 days
When should you use emergency contraception if on CHC?
If you forget 2-3 pills in 1st 7 days and UPSI occurred in those days
What are some non-contraceptive reasons to take COC?
Heavy periods Painful periods Irregular periods Acne Endometriosis Menstural migraines Hirsutism
How do progesterone only pills work?
Inhibit ovulation
What are the names of 2 progesterone only pills?
Cerezelle
Cezette
How many years does the progesterone only implant provide protection for?
3 years
TRUE/FALSE
The bleeding in the first 3 months of the progesterone only implant is heavy but it will relax
LIES
The bleeding pattern in the first 3 months are broadly predictive of future bleeding patterns
How long do the progesterone injections last?
14 weeks
What can the progesterone implants cause?
Osteoporosis
How does the IUS affect implantation?
The endometrium is rendered unfavourable
TRUE/FALSE
The IUS makes periods lighter and less painful
TRUE
How long does the IUS last?
5 years
Barrier methods of contraception stop all transmission of STDs TRUE/FALSE
FALSE
Obv never 100% certain but also it does not reduce transmission of STDs affecting the perineum
OIL based lubricants are the best to use TRUE/FALSE
FALSE
It destroys the latex
When is the most fertile time in a woman menstural cycle?
6 days prior to ovulation and 2 days afterwards
DAYS 8-18
By how much does the basal body temperature increase during ovulation?
> 0.2 degrees c
If using cervical mucous as a way fo determining when you are fertile when should you avoid sex in order to not become pregnant?
No intercourse from the day mucous becomes slippery to 3 days after it becomes tacky
What 3 things must be true in order to meet the criteria for lactation amenorrhoea?
1- Exclusively breastfeeding
2-Less than 6-12h postnatal
3-Amenorrhoeic
When can emergency contraception be used?
Can be used up to 5 days post UPSI
OR
Within 5 days of predicted date of ovulation
COPPER IUD is more effective than oral TRUE/FALSE
True- 10x more effective
What are the 3 methods by which the copper coil works?
1- inhibit fertilisation
2- Inhibit implantation
3-Stop sperm penetration (as they are toxic to sperm)
In general when can LARC be inserted?
If there has been no UPSI in the last 3 weeks
What is the only emergency contraception that can be used after ovulation?
Copper IUD
SE of Copper IUD
Periods heavy
Crampy
Menorrhagia/Dysmonorrhoea
What are the two types of oral emergency contraception?
LNG-EC
UPA-EC
How does LNG-EC work?
Contains Levonorgestrel
Up to 72h
High dose progesterone
Works until just before LH surge
With oral EC you need to give a double dose if their BMI is >26 TRUE/FALSE
FALSE
Need to give double dose with LNG but not UPA
How long post-UPSI does UPA-EC work?
120h
What does UPA-EC contain?
3-mg Ulipristal acetate e.g. EllaOne
How does UPA-EC work?
Anti-progesterone
Can work during LH surge but not after
Which of the oral contraceptives can only be used once in a menstural cycle?
UPA-EC
