Contraception Flashcards
What is the pearl index and what is the formula for it?
Represents the no. of contraceptive failures per 100 women in a year.
No. of accidental pregnancies X1200 / total no. months exposure
List some of the natural family planning methods considered.
Basal body temperature. cervical mucous cervical position standard days Breastfeeding
What is the basis of the BBT concept in natural family planning?
Woman records temperature first thing in morning and is waiting for a rise of 0.2 degrees which is maintained for 3 days - indicates ovulation has occurred & fertile period passed.
The couple avoid sex from first day of bleeding until 3 days after rise in temp - to avoid fertile period.
Couple can have unprotected sex on 4th day and until next monthly bleed begins.
Describe cervical position when fertile and infertile.
Cervix is high in vagina, soft & open when fertile.
Cervix is low, firm and closed when infertile.
During a 28 day cycle, which days is a female most fertile?
standard days = days 8-18
What is lactational amenorrhoea and what are the criteria which need to be met to do this?
The natural family planning method which revolves around the fact that females don’t ovulate when breastfeeding.
3 criteria:
exclusively breastfeeding
<6/12 post-natal
amenorrhoeic
When can you start combined hormonal contraception in a patient?
start in first 5 days of period
Or
at any time in cycle when reasonably sure not pregnant + use condoms for 7 days
What is the main side effect of the subdural contraceptive implant?
prolonged PV bleeding - can be controlled by CHC taken additionally if not contraindicated.
What are the uses of Mirena IUS?
heavy periods
can be part of HRT
therapeutic use in endometriosis, hyperplasia etc.
What is the mode of action of the copper coil?
Primary action is prevention of fertilisation. It also causes an inflammatory response in the endometrium which has an effect on implantation.
Combined hormonal contraception has a protective effect over breast and cervical cancer.
T/F?
FALSE
protection from ovarian and endometrial cancers and increased risk for breast cancer and cervical cancer.
When should you check the BP of a patient you are starting on CHC?
check initially, at 3 months and then annually.
CHC is contraindicated in patients with migraines.
T/F?
FALSE
contraindicated in patients with migraine WITH AURA (increases risk of ischaemic stroke)
What is the definition of Quick starting contraception?
starting contraception when patient presents i.e. not waiting until next period.
(i.e. may not be possible to reliably exclude pregnancy = off-licence)
What is the definition of bridging contraception?
when the preferred method can’t be started immediately because pregnancy cannot be excluded, and an interim method is used.
When is there a 30% pregnancy risk during the menstrual cycle?
within 6 days before ovulation
What are the 3 methods of emergency contraception available in the UK?
intrauterine - copper IUD
oral - LNG-EC and UPA-EC
What is the timescale of use of LNG-EC?
up to 72hrs post-UPSI (up to 96hrs off-licence)
What is the timescale of use of UPA-EC?
up to 120hrs post-UPSI
The copper IUD is more effective than oral EHC.
T/F?
TRUE
10x more effective than oral EHC
What is the insertion criteria for copper IUD as EC?
up to 120hrs post-UPSI
OR
up to 5 days after earliest expected date of ovulation
What are the side effects of copper IUD and how can these be managed?
often make periods heavier, longer and more painful - esp. during the 3/12 post-insertion.
NSAIDs can help with both pain and bleeding
Which form of contraception might be the only suitable reliable method for women after breast cancer?
copper IUD
Out of the 2 oral EC, which is anti-progestogen and which is high-dose progestogen?
UPA-EC = anti-progestogen LNG-EC = high-dose progestogen
