Contraception Flashcards
Combined oral contraceptive pill (COCP) contains?
Oestrogen and progesterone
Mechanism of COCP?
Prevent ovulation
Thickens cervical mucus
Thins the endometrium
Types of COCP?
Monophasic
Phasic
Daily
Monophasic COCP?
Microgynon
Yasmine
Same pill for 21 days, 7 day gap for withdrawal bleed
Phasic COCP?
Logynon
Pill for 21 days, 7 day gap for withdrawal bleed
Hormonal levels vary to match changes in menstrual cycle
Must be taken in order
Daily COCP?
Microgynon ED
21 pills and 7 sugar pills
Take the pill every day and accounts for withdrawal bleed
Common side effects of COCP?
Headaches Breakthrough bleeding Improving/worsening acne Changes in libido Breast tenderness
Risks of COCP?
Hypertension
Thrombosis
Increased risk of breast cancer (but reduced risk of endometrial, ovarian and cervical cancer)
Contraindications of COCP?
Over 35 and smoker Pregnancy Previous DVT/PE Previous stroke/MI Uncontrolled hypertension Family history of thrombosis Migraine with aura Breast cancer
Progesterone only pill, minipill, examples?
Cerazette
Older - micronor, norgeston
Side effects of POP?
Acne Headache Breast tenderness Irregular bleeding Change in libido
Two types of intrauterine devices?
Copper coil
Levonorgestrel-releasing coil (Mirena coil)
Copper coil mechanism?
Prevents fertilisation
Copper is spermicidal
Benefits of copper coil?
Can be inserted at any time during menstrual cycle
Hormone free
Can be used as emergency contraception up to 5 days after unprotected sex
Drawbacks on copper coil?
Can increase periods
Uterine perforation (rare)
Increased risk of ectopic pregnancies
Can occasionally fall out
Mirena coil mechanism?
Prevent fertilisation
Thickens cervical mucus
Reduces endometrial thickening
Benefits of Mirena coil?
Can make periods lighter or stop altogether
Most bleed free after 1 year
(1st line treatment of menorrhagia where pregnancy is not desired)
Drawbacks of Mirena coil?
Irregular bleeding
Alternative contraception is required for 7 days
Depo-provera?
3 monthly injection of medroxyprogesterone acetate
Depo-provera mechanism?
Prevents ovulation
Thickens cervical mucus
Side effects of depo-provera?
Amenorrhoea Irregular bleeding Weight gain Acne Osteoporosis risk, affects bone density Can take 12 months for fertility to return
Progesterone implant?
Nexplanon, lasts for 3 years
Implant mechanism?
Inhibits ovulation
Thickens cervical mucus
Thins the endometrium
Benefits of implant?
No need to remember to take a pill every day
Can improve dysmenorrhoea
Does not affect bone mineral density
