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Gynae AM > Contraception > Flashcards

Contraception Flashcards

1
Q

What are the methods of contraception?

A

Barrier
Daily
Long acting reversible
Long acting irreversible

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2
Q

What are some methods of barrier contraception?

A

Condom
Femidom
Diaphragm

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3
Q

What are some daily methods oc contraception?

A

Combined OCP

Progesterone only pill POP

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4
Q

What are some long acting reversible methods of contraception?

A

Implant
Injection
IUS
IUD

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5
Q

How does the combined pill work?

A

Inhibits ovulation

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6
Q

What are some advantages of combined pill?

A

Period control- can take 3 packs back to back then take 4 or 7 day break- more likely to result in breakthrough bleeding

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7
Q

What are some disadvantages of combined pill?

A

Increased risk VTE, breast and cervical cancer

Made ineffective by antibiotics and enzyme inducing drugs

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8
Q

What are the absolute contraindications to the combined pill?

A 
Migraine with aura
PMH thromboembolism
PMH strke/IHD
Uncontrolled hypertension
Current breast cancer
MAjor surgery within 4 weeks
Breastfeeding and <6 weeks postpartum
>35yo smoking >15/day
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9
Q

What are some instances where the combined pill is not recommended?

A 
BMI >35
FH thromboembolism in <45yo
Controlled hypertension
Current gallbladder disease
BRCA 1 or 2 
Immbolity
>35yo smoking <15/day
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10
Q

What do you do will 1 missed poll combined OCP?

A

Take when you remember, even if it means taking 2 at once

No extra precautions necessary

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11
Q

What do you do when you miss 2 combined pills?

A

Take 2 pills at once then continue as normal

Use additional methods for 7 days

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12
Q

How does the POP work?

A

Thickens cervical mucus

Desogestrel- thickens cervical mucus and inhibits ovulation

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13
Q

What are the advantages of the POP?

A

No absolute contraindications
Can stop periods entirely
No oestrogen
Effective wthin 2 days

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14
Q

What are the disadvantages of the POP?

A

Must be taken within 3 hour (or 12 for desogestrel) window daily

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15
Q

How does the implant work?

A 
Primary= inhibits ovulation
Secondary= thickens cervical mucus
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16
Q

What are the advantages of the implant?

A

Lasts 3 years
No oestrogen
Lower hormone dise

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17
Q

What is a disadvantage of the implant?

A

Irregular bleeding

Need trained professional t insert

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18
Q

What is the injection?

A

Depo-Provera

Injection every 12 weeks

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19
Q

What is the method of Depo-Provera?

A 
Primary= inhibit ovulation
Secondary= thicken cervical mucus
20
Q

What are some disadvantages of the injction?

A

Weigh gain
Bone density decrease
Return to fertility can take ~1 year

21
Q

What is the method of action of the IUS?

A 
Primary= prevents endometrial proliferation
Secondary= thickens cervical mucus
22
Q

What are some advantages of the IUS?

A

Long term

1st line management of dysmenorrhoea

23
Q

What are some disadvantages of the IUS?

A

Irregular bleeding

24
Q

How does the IUD woek?

A

Decreased sperm motility and survival

25
Q

What are some advantages of the IUD?

A

Can be inserted any time
Can be used as emergency contraception
Hormone free
Long term

26
Q

What are some disadvantages of the IUD?

A

Can make periods longer, heavier and more painful

27
Q

What is the failure rate of sterilisation?

A

1 in 200

28
Q

What are some disadvantages of sterilisation?

A

Major operation
General anaesthetic usually
Reversal complicated and rarely works

29
Q

What is the failure rate of vasectomy?

A

1 in 2000

30
Q

What are some complications of vasectomy?

A

Bruising
infection
Sperm granuloma
Chronic testicular pain

31
Q

What is the % success of vasectomy reversal?

A

<10 years= 55%

>10 years= 25%

32
Q

What are the options for emergency contraception?

A

Levonorgestrel= levonelle
Ulipristal acetate= ellaOne
IUD

33
Q

When can levonorgestrel be taken?

A

Within 72 hours

Efficacy decreases with time

34
Q

What is the dose of levonelle?

A

Single dose 1.5mg

-double dose if BMI >26 or >70kg

35
Q

What are some advantages of levonelle?

A

Can be used more than once per menstrual cycle
Doesn’t interfere with other hormonal contraception
Can be used while breastfeeding

36
Q

When can ellaOne be taken?

A

Within 120 hours

Efficacy doesn’t decreae with time

37
Q

What is the dose of ellaOne?

A

Single dose 30mg

38
Q

What are some disadvantages of ellaOne?

A

Can interfere with other hormonal contraception for 5 days

Cannot be used while breastfeeding

39
Q

When can the IUD be used as emergency contraception?

A

Within 5 days or 5 days after likely date of ovulation

Can remain in situ as long term contraception

40
Q

When is contraception required postpartum?

A

After 21 days

41
Q

When can the POP be started postpartum?

A

From day 21

42
Q

When can the combined pill be started post partum?

A

Breastfeeding= absolute contraindication until 6 weeks, not preferred until 6 months
Not breastfeeding= day 21

43
Q

When can the IUS/IUD be used postpartum?

A

Within 48 hours or after 4 weeks

44
Q

When can contraception be stopped in menopausal women?

A 
<50= 2 years of amenorrhoea
>50= after 1 years amenorrhoea
45
Q

What contraceptive options can <50s use?

A

All available

46
Q

What contraceptive options are contraindicatd in >50s?

A

Combined OCP

Depo-Provera

47
Q

What contraceptive options are there for >50s?

A

Implant
POP
IUS
IUD

Gynae AM (17 decks)

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