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J Repro > Contraception > Flashcards

Contraception Flashcards

1
Q

indication for condoms

A

STIs

irregular partners

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2
Q

are condoms 100% effective

A

no may break

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3
Q

what is the mechanism of action of condoms

A

barrier - doesn’t allow sperm to enter vagina

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4
Q

what is the most common type of contraception

A

combined oral contraceptive pill (COCP)

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5
Q

indications for COCP

A

first contraception/young
irregular periods
ovarian/endometrial cancer risk
acne/hirsutism

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6
Q

what contraceptives are advised if irregular periods

A

COCP

mirena coil - if heavy

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7
Q

which cancers do you prescribe COCP to reduce the risk of (eg family history)

A

endometrial cancer
ovarian cancer

(lynch syndrome)

THINK: not the 2 that you screen for (breast and cervical)

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8
Q

what contraceptive can you prescribe for acne

A

COCP

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9
Q

what neuro symptom is a contraindication for COCP

A

migraine (with aura)

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10
Q

contraindications for COCP

A

migraine with aura
poor compliance
DVT risk
breast cancer risk - BRCA gene mutation

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11
Q

which cancer does COCP increase your risk of

A 
breast cancer (don't give if BRCA gene mutation)
cervical cancer
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12
Q

what vascular condition does COCP increase your risk of

A

DVT

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13
Q

risk factors for DVT (ie shouldn’t give COCP)

A 
obese 
hypertension 
>35
smoker 
6 weeks post partum 
antiphospholipid syndrome
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14
Q

why is there an increased risk of DVT in COCP

A

increased clotting factors

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15
Q

how do you take a COCP

A

21 days pill 7 days pill free (get a ‘period’ then)

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16
Q

how do combined hormonal contraceptives work (COCP, ring, patch)

A

inhibits ovulation = no eggs released to be fertilized (mainly)

thickens cervical mucosa = hard for sperm to get in

thins endometrium = implantation less likely

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17
Q

how often do you change a combined hormonal ring

A

once per month

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18
Q

how often do you change a combined hormonal patch

A

once per week

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19
Q

failure rates of COCP (pearl index)

A

0.2% if taken properly

realistically 9% with typical use

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20
Q

side effects of progesterone only pill/implant/injection

A

irregular bleeding

can give COCP on top (eg if implant) to sort this

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21
Q

contraindications for progesterone only pill/implant/injection

A

breast cancer risk - BRCA gene, Fx

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22
Q

how do progesterone only contraceptives work (implant, pill (POP), injection)

A

inhibits ovulation via negative feedback (decreased FSH and LH) = no eggs released to be fertilized (mainly)

thickens cervical mucosa = hard for sperm to get in

thins endometrium = implantation less likely

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23
Q

which type of contraception has the best effectiveness (lowest pear index)

A

progesterone only implant (0.05% failure rate)

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24
Q

which type of contraception is immediately effective = don’t need to use condoms (the others you do) (2)

A

progesterone only implant

copper coil

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25
LARC (long acting reversible contraceptive) examples (4)
implant depo injection coil coper coil
26
contraindications to progesterone only depo injection
osteoporosis risk - low BMD, BMI <20, malabsorption
27
is male sterilization (vasectomy) reversible or irreversible
irreversible!
28
is female sterilization reversible or irreversible
irreversible!
29
contraindications to female sterilization
PID
30
indications for intrauterine system (IUS) - mirena/jaydess coil
menstrual pain and heavy bleeding | liver enzyme inducing drugs - cant take systemic hormonal stuff, needs to be local to ovaries
31
contraindication for intrauterine device (IUD) - copper coil
menstrual pain and heavy bleeding
32
which contraceptives are the options for someone taking a liver enzyme inducing drug
mirena/jaydess coil -bc local to the ovaries contraindicated - systemic hormonal things (need to go through the liver)
33
contraindications for mirena/jaydess coil (IUS) (4)
pregnancy!! - need 3 weeks abstinence before insertion uterine abnormalities - PID, fibroids, unexplained bleeding risk of cervical/endometrial/breast cancer long QT
34
indications for coper coil (IUD)
BREAST CANCER risk - all hormonal stuff is contraindicated | mental health issues - all hormonal stuff is contraindicated
35
contraceptive for someone with BRCA gene mutation why
copper coil bc don't want hormones if risk of breast cancer
36
contraceptive for someone with mental health issues
copper coil bc don't want hormone alteration
37
what MUST you exclude before giving someone a coil (hormonal or copper) why
exclude pregnancy - 3 weeks of abstinence first insertion of coil will cause an abortion
38
contraindications for copper coil (IUD) (4)
pregnancy!! - need 3 weeks abstinence before insertion uterine abnormalities - PID, fibroids, unexplained bleeding risk of cervical/endometrial cancer long QT menstrual pain and bleeding
39
how long does mirena coil last
5 years
40
how long does jaydess coil last
3 years
41
when do you insert a copper coil
just after a period
42
how long does a copper coil last
5-10 years
43
how does hormonal coil work as a contraceptive
thins endometrium = prevents implantation | also hormones = prevent egg release
44
how does copper coil work as a contraceptive
copper prevents fertilization and implantation - no hormones involved!
45
side effects of copper coil
pain and worse bleeding
46
how long does sperm live in female genital tract for
5 days
47
up to how many days after a period can you have sex and not be worried about pregnancy
<7 days
48
what does breast feeding do to your periods
causes lactational amenorrhoea = no periods for 6 months = acts as a natural contraceptive
49
for COCP depo injection and implant, when should you start contraception do you need any extra protective measures
day 1-5 of period don't need any extra protective measures
50
if you start COCP anytime during cycle, how many days should you use a condom for afterwards
7 days
51
what happens if you miss 1 COCP what should you do
nothing don't worry just take again as soon as you remember
52
what happens if you miss 2 COCP what should you do
egg may/may not be released take it again as soon as you remember use condom for 7 days
53
if you take a POP >3 hours too late, what do you need to do
use condom for 2 days
54
indications for implant
young but poor compliance - probs doesn't want a coil
55
which contraceptive is contraindicated in breast feeding women 0-6 months post partum why
COCP bc of DVT risk
56
which contraceptive is contraindicated in smokers/obese people >35 why
COCP bc of DVT risk
57
which contraceptive is contraindicated in people with Fx CVD | why
COCP bc of DVT risk
58
which contraceptive is contraindicated in people uterus problems eg PID, fibroids etc why
coil - hormonal or copper
59
how often do you get an injection if on progesterone depo injection
every 13 weeks
60
in what time period around ovulation should you be worried about unprotected sex why when is ovulation
ovulation is day 14 after period starts unprotected sex 5 days before until 1 day after ovulation sperm stays in female genital tract for 5 days eggs stay in female genital tract for 1 day after ovulation
61
options for emergency contraception (3)
levonorgestrel (LNG-EC) EllaOne (UPA-EC) copper coil (IUD)
62
how many days after unprotected sex can you take levonorgestrel (LNG-EC) and it still be effective
3 days
63
how many days after unprotected sex can you take EllaOne (UPA-EC) and it still be effective
5 days
64
how many days after unprotected sex can you have the copper coil inserted and it still be effective
5 days
65
what type of drug is levonorgestrel (LNG-EC) how does it work
high dose progesterone = negative feedback decreases LH and FSH = delays ovulation
66
what type of drug is EllaOne (UPA-EC) how does it work
anti-progesterone = blocks progesterone = delays ovulation
67
which is the best type of emergency contraception
``` copper coil (IUD) - x10 more effective than pill works before and after ovulation ``` can be kept in for long term contraception after
68
which guidance criteria is used when prescribing contraceptives to under 16yos
fraser guidance - assess childs capacity to understand contraception

J Repro (28 decks)

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