Contraception Flashcards
Average conception rate per mid cycle intercourse
30%
Vasectomy failure rate
1:2000
Should not have unprotected intercourse until 3 months post procedure and a negative semen analysis
In women undergoing treatment for breast cancer, POPs do what to the rate of disease recurrence?
Increase
When can PCC be inserted up to in terms of day of cycle?
Day 19 of a 28 day cycle
When to insert copper IUD for emergency contraception
99% effective if inserted up to 120 hours after unprotected sex
**this is the gold standard method
Oral ECP type dose and timing
Levonorgestrel 1.5mg
72 hours (85% effective)
2-3% pregnancy rate after use
OR
Ulipristal acetate 30mg 120 hours (85% effective) 1-2% pregnancy rate after use
Natural family planning methods
The calendar method Basal body temperature method Billings method (ovulatory mucus) Cervical palpatine method Lactation also amenorrhea
Rhythm method
Length of menstrual cycle
Ovulation calculated as 14 day prior to onset of expected menstruation
Advantages of natural family planning
May be only option for those with religious or cultural belief
Not medical, no need to come to clinic
Makes women aware of ovulation cycle and natural fertility
Can enhance commuication and cooperation within a relationship
Disadvantages of natural family planning
Removes spontaneity of intercourse
Variation in length of follicular phase of the menstrual cycle which can indtroduce inaccuracies in ovulation prediction
Reliability of fertility awareness methods is likely to be reduced during BF, when discontinuing hormonal methods or during peri menopause
Types of combined hormonal contraception
Pills- Monophasic and bi/tri-physic
Transdermal patch
Vaginal ring
Combined contraception mode of action
Inhibit ovulation
Alters cervical mucus to reduce sperm penetration
Alters the endometrium, making it atrophic and unreceptive to implantation
Effectiveness of combined hormonal contraception
0.2 - 8:100 pregnancies depending on reliability of use
Advantages of combined hormonal contraception
Effective with correct use
Reliable
Reversible
Independent of intercourse
Can be used to treat menstraul problems
Can improve acne
Can be useful in managing symptoms of PCOS
Decreased risk of benign conditions in current users
Long term reduction in risk of carcinoma of the endometrium, ovary and bowel
Allows manipulation of the time of menstruation
Can assist with management of perimenopausal symptoms
Disadvantages of CHC
User-dependent (can reduce efficacy)
Minor hormonal SE (nausea, fluid retention, weight gain, breast tenderness)
Increased risk of VTE
Increased risk of arterial disease in the presence of other risk factors
Interactions with some drugs causes reduction of efficacy
Concomitant illness can affect absorption and reduce efficacy
