Contraception Flashcards
What are the methods of contraception?
Barrier
Daily
Long acting reversible
Long acting irreversible
What are some methods of barrier contraception?
Condom
Femidom
Diaphragm
What are some daily methods oc contraception?
Combined OCP
Progesterone only pill POP
What are some long acting reversible methods of contraception?
Implant
Injection
IUS
IUD
How does the combined pill work?
Inhibits ovulation
What are some advantages of combined pill?
Period control- can take 3 packs back to back then take 4 or 7 day break- more likely to result in breakthrough bleeding
What are some disadvantages of combined pill?
Increased risk VTE, breast and cervical cancer
Made ineffective by antibiotics and enzyme inducing drugs
What are the absolute contraindications to the combined pill?
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
What are some instances where the combined pill is not recommended?
BMI >35 FH thromboembolism in <45yo Controlled hypertension Current gallbladder disease BRCA 1 or 2 Immbolity >35yo smoking <15/day
What do you do will 1 missed poll combined OCP?
Take when you remember, even if it means taking 2 at once
No extra precautions necessary
What do you do when you miss 2 combined pills?
Take 2 pills at once then continue as normal
Use additional methods for 7 days
How does the POP work?
Thickens cervical mucus
Desogestrel- thickens cervical mucus and inhibits ovulation
What are the advantages of the POP?
No absolute contraindications
Can stop periods entirely
No oestrogen
Effective wthin 2 days
What are the disadvantages of the POP?
Must be taken within 3 hour (or 12 for desogestrel) window daily
How does the implant work?
Primary= inhibits ovulation Secondary= thickens cervical mucus
What are the advantages of the implant?
Lasts 3 years
No oestrogen
Lower hormone dise
What is a disadvantage of the implant?
Irregular bleeding
Need trained professional t insert
What is the injection?
Depo-Provera
Injection every 12 weeks
What is the method of Depo-Provera?
Primary= inhibit ovulation Secondary= thicken cervical mucus
What are some disadvantages of the injction?
Weigh gain
Bone density decrease
Return to fertility can take ~1 year
What is the method of action of the IUS?
Primary= prevents endometrial proliferation Secondary= thickens cervical mucus
What are some advantages of the IUS?
Long term
1st line management of dysmenorrhoea
What are some disadvantages of the IUS?
Irregular bleeding
How does the IUD woek?
Decreased sperm motility and survival
What are some advantages of the IUD?
Can be inserted any time
Can be used as emergency contraception
Hormone free
Long term
What are some disadvantages of the IUD?
Can make periods longer, heavier and more painful
What is the failure rate of sterilisation?
1 in 200
What are some disadvantages of sterilisation?
Major operation
General anaesthetic usually
Reversal complicated and rarely works
What is the failure rate of vasectomy?
1 in 2000
What are some complications of vasectomy?
Bruising
infection
Sperm granuloma
Chronic testicular pain
What is the % success of vasectomy reversal?
<10 years= 55%
>10 years= 25%
What are the options for emergency contraception?
Levonorgestrel= levonelle
Ulipristal acetate= ellaOne
IUD
When can levonorgestrel be taken?
Within 72 hours
Efficacy decreases with time
What is the dose of levonelle?
Single dose 1.5mg
-double dose if BMI >26 or >70kg
What are some advantages of levonelle?
Can be used more than once per menstrual cycle
Doesn’t interfere with other hormonal contraception
Can be used while breastfeeding
When can ellaOne be taken?
Within 120 hours
Efficacy doesn’t decreae with time
What is the dose of ellaOne?
Single dose 30mg
What are some disadvantages of ellaOne?
Can interfere with other hormonal contraception for 5 days
Cannot be used while breastfeeding
When can the IUD be used as emergency contraception?
Within 5 days or 5 days after likely date of ovulation
Can remain in situ as long term contraception
When is contraception required postpartum?
After 21 days
When can the POP be started postpartum?
From day 21
When can the combined pill be started post partum?
Breastfeeding= absolute contraindication until 6 weeks, not preferred until 6 months
Not breastfeeding= day 21
When can the IUS/IUD be used postpartum?
Within 48 hours or after 4 weeks
When can contraception be stopped in menopausal women?
<50= 2 years of amenorrhoea >50= after 1 years amenorrhoea
What contraceptive options can <50s use?
All available
What contraceptive options are contraindicatd in >50s?
Combined OCP
Depo-Provera
What contraceptive options are there for >50s?
Implant
POP
IUS
IUD
