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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
Q

LARC (long acting reversible contraceptive) examples (4)

A

implant
depo injection
coil
coper coil

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26
Q

contraindications to progesterone only depo injection

A

osteoporosis risk - low BMD, BMI <20, malabsorption

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27
Q

is male sterilization (vasectomy) reversible or irreversible

A

irreversible!

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28
Q

is female sterilization reversible or irreversible

A

irreversible!

29
Q

contraindications to female sterilization

A

PID

30
Q

indications for intrauterine system (IUS) - mirena/jaydess coil

A

menstrual pain and heavy bleeding

liver enzyme inducing drugs - cant take systemic hormonal stuff, needs to be local to ovaries

31
Q

contraindication for intrauterine device (IUD) - copper coil

A

menstrual pain and heavy bleeding

32
Q

which contraceptives are the options for someone taking a liver enzyme inducing drug

A

mirena/jaydess coil -bc local to the ovaries

contraindicated - systemic hormonal things (need to go through the liver)

33
Q

contraindications for mirena/jaydess coil (IUS) (4)

A

pregnancy!! - need 3 weeks abstinence before insertion
uterine abnormalities - PID, fibroids, unexplained bleeding
risk of cervical/endometrial/breast cancer
long QT

34
Q

indications for coper coil (IUD)

A

BREAST CANCER risk - all hormonal stuff is contraindicated

mental health issues - all hormonal stuff is contraindicated

35
Q

contraceptive for someone with BRCA gene mutation

why

A

copper coil

bc don’t want hormones if risk of breast cancer

36
Q

contraceptive for someone with mental health issues

A

copper coil

bc don’t want hormone alteration

37
Q

what MUST you exclude before giving someone a coil (hormonal or copper)

why

A

exclude pregnancy - 3 weeks of abstinence first

insertion of coil will cause an abortion

38
Q

contraindications for copper coil (IUD) (4)

A

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
Q

how long does mirena coil last

A

5 years

40
Q

how long does jaydess coil last

A

3 years

41
Q

when do you insert a copper coil

A

just after a period

42
Q

how long does a copper coil last

A

5-10 years

43
Q

how does hormonal coil work as a contraceptive

A

thins endometrium = prevents implantation

also hormones = prevent egg release

44
Q

how does copper coil work as a contraceptive

A

copper prevents fertilization and implantation - no hormones involved!

45
Q

side effects of copper coil

A

pain and worse bleeding

46
Q

how long does sperm live in female genital tract for

A

5 days

47
Q

up to how many days after a period can you have sex and not be worried about pregnancy

A

<7 days

48
Q

what does breast feeding do to your periods

A

causes lactational amenorrhoea = no periods for 6 months

= acts as a natural contraceptive

49
Q

for COCP depo injection and implant, when should you start contraception

do you need any extra protective measures

A

day 1-5 of period

don’t need any extra protective measures

50
Q

if you start COCP anytime during cycle, how many days should you use a condom for afterwards

A

7 days

51
Q

what happens if you miss 1 COCP

what should you do

A

nothing don’t worry

just take again as soon as you remember

52
Q

what happens if you miss 2 COCP

what should you do

A

egg may/may not be released

take it again as soon as you remember
use condom for 7 days

53
Q

if you take a POP >3 hours too late, what do you need to do

A

use condom for 2 days

54
Q

indications for implant

A

young but poor compliance

  • probs doesn’t want a coil
55
Q

which contraceptive is contraindicated in breast feeding women 0-6 months post partum
why

A

COCP

bc of DVT risk

56
Q

which contraceptive is contraindicated in smokers/obese people >35
why

A

COCP

bc of DVT risk

57
Q

which contraceptive is contraindicated in people with Fx CVD

why

A

COCP

bc of DVT risk

58
Q

which contraceptive is contraindicated in people uterus problems eg PID, fibroids etc
why

A

coil - hormonal or copper

59
Q

how often do you get an injection if on progesterone depo injection

A

every 13 weeks

60
Q

in what time period around ovulation should you be worried about unprotected sex

why

when is ovulation

A

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
Q

options for emergency contraception (3)

A

levonorgestrel (LNG-EC)
EllaOne (UPA-EC)
copper coil (IUD)

62
Q

how many days after unprotected sex can you take levonorgestrel (LNG-EC) and it still be effective

A

3 days

63
Q

how many days after unprotected sex can you take EllaOne (UPA-EC) and it still be effective

A

5 days

64
Q

how many days after unprotected sex can you have the copper coil inserted and it still be effective

A

5 days

65
Q

what type of drug is levonorgestrel (LNG-EC)

how does it work

A

high dose progesterone = negative feedback decreases LH and FSH = delays ovulation

66
Q

what type of drug is EllaOne (UPA-EC)

how does it work

A

anti-progesterone = blocks progesterone = delays ovulation

67
Q

which is the best type of emergency contraception

A 
copper coil (IUD) - x10 more effective than pill 
works before and after ovulation

can be kept in for long term contraception after

68
Q

which guidance criteria is used when prescribing contraceptives to under 16yos

A

fraser guidance - assess childs capacity to understand contraception

J Repro (28 decks)

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