Contraception Flashcards

1
Q

What is meant by a ‘99%’ effectiveness with regards to contraception?

A

That an average person using this method of contraception properly with a regular partner for a single year would only have a 1% change of getting pregnant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is UKMEC used for?

Outline the 4 levels of UKMEC

A

To assess the safety of different contraceptive methods based on individuals

UKMEC1 = no restriction in use
UKMEC2 = advantages > disadvantages
UKMEC3 = disadvantages > advantages 
UKMEC4 = unacceptable risk, contraindicated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the effectiveness of the COCP if taken properly?

A

> 99%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the main mechanism of action of the COCP as contraception?

State two other actions

A

Prevents ovulation

Thickens cervical mucus
Thins endometrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the different ways to take the the COCP (different types)? (3)

Describe each one

A

Monophasic - identical pills taken every day for 21 days followed by 7 day gap

Phasic - one pill taken every day for 21 days followed by 7 day gap, but pills contain varying amounts of hormones (need to be taken in correct order)

Every day - pill taken everyday, 7 are inactive placebo pills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are common side effects of the COCP?

A
Breakthrough bleeding/spotting
Breast tenderness
Headaches/migraines
Changes in libido
Acne
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some risks associated with COCP use?

A

Stroke
DVT
HTN
Increased risk of breast cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What effect does COCP use have on cancer risk?

A

Increased risk - breast cancer

Reduced risk - endometrial, ovarian and colon cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some UKMEC 4 contraindications for COCP use?

A
Over 35 + smoker
Pregnancy
Previous thrombosis
Previous stroke/heart disease
Uncontrolled HTN
FH thrombosis
Migraine with aura
Breast cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When should the COCP be started to offer immediate protection?

A

First day of the cycle (first day of menstrual period)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the missed pill rule for ONE missed pill?

A

Take missed pill as soon as possible, no extra protection required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If you start the COCP not on the first day of the cycle, what precautions should be taken?

A

Barrier contraception for 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How should switching of combined pill types be done?

A

Once 21 days of first pill is over, start 21 days of new pill immediately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name two types of COCP

A

Microgynon

Yasmine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is the POP taken differently to the COCP?

A

POP is taken continuously

COCP is taken cyclically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does the POP work as contraception? (2)

A

Thickens cervical mucus

Prevents ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the effectiveness of the POP if taken perfectly?

A

> 99%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What time of the day should traditional POP be taken?

A

Within the same 6 hour window every day (3 hours +/- the same time from day before)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name two types of POP

A

Norethisterone (traditional)
Levonorgestrel (traditional)
Desogestrel (new gen, 24 hr window)

20
Q

What are some side effects of the POP?

A
Irregular bleeding
Amenorrhoea
Breast tenderness
Headaches
Change in libido
Acne
21
Q

What are the two types of IUD?

What is their effectiveness if inserted properly?

A

Copper coil

Mirena coil

> 99%

22
Q

What is the mechanism of action of the copper coil?

When is it effective after insertion?

A

Reduces sperm motility and survival

Effective immediately

23
Q

What is an alternative use for the copper coil other than traditional contraception?

A

Emergency contraception - inserted up to 5 days after unprotected intercourse

24
Q

What are some of the side effects/complications associated with copper IUD?

A

Menorrhagia/IMB (improves over time)
Uterine perforation/PID on insertion
Increased risk of ectopic pregnancies

25
What is the mechanism of action of the Mirena coil?
Releases levonorgestrel (progestogen) to thicken the cervical mucus and reduce endometrial thickening
26
How can the Mirena coil affect bleeding?
Can make periods lighter or stop altogether Can cause irregular bleeding
27
What are the side effects associated with the Mirena coil?
Spotting/irregular bleeding PID/uterine perforation (more rare) Increased risk of ectopic pregnancies
28
What is the alternative use of the Mirena coil other than for traditional contraception?
First line treatment for menorrhagia (where pregnancy not desired)
29
What does the Depo-provera injection contain? How often is it taken?
Medroxyprogesterone acetate (progestogen) 3 monthly IM injection
30
How effective is a regular 3 monthly Depo provera injection as contraception?
> 99%
31
What is the mechanism of action of the Depo provera injection? (2)
Prevents ovulation | Thickens cervical mucus
32
How long can it take for fertility to return in women who take the Depo provera injection as contraception?
12 months
33
When should the Depo provera injection be given to provide immediate contraception? What precaution should be taken if started at any other time?
First day of cycle (menstrual period) 7 day barrier contraception
34
What side effects are associated with the Depo provera injection?
``` Amenorrhoea Irregular bleeding WEIGHT GAIN Acne OSTEOPOROSIS ```
35
Which contraceptive method is the only one to have a proven association with weight gain?
Depo provera injection
36
What is the name of the implant used as contraception in the UK? Which hormone does it release?
NEXPLANON Progesterone
37
How long is the progesterone implant effective for?
3 years
38
What is the mechanism of the progesterone implant?
Same as POP - Inhibits ovulation - Thins endometrium - Thickens cervical mucus
39
What side effects are associated with progesterone implant use?
Minor operation required to insert/remove Acne Bleeding changes Reduced libido
40
For how long after giving birth, do all women not require contraception?
21 days after giving birth, no contraception required
41
What contraception is considered safe in breastfeeding? When can it be started?
POP Any time
42
Can the COCP be used whilst breastfeeding?
Should be avoided UKMEC4 before 6 weeks UKMEC2 after 6 weeks
43
Is lactational amenorrhoea (full breastfeeding + no periods) effective as contraception? For how long?
98% effective as contraception for 6 months
44
What contraceptives are contraindicated if mother is not breastfeeding?
Any contraceptive is fine
45
What are three types of emergency contraception?
Levonorgestrel - POP Ulipristal - progesterone receptor modulator Copper IUD
46
How is female sterilisation performed?
Laparoscopically under GA Blockage, tying, cutting or removal of Fallopian tubes
47
How is male sterilisation performed?
Vasectomy, quick procedure under LA Cutting and tying of vas deferens to prevent sperm reaching semen