Contraception Flashcards

(58 cards)

1
Q

What is the combined oral contraceptive pill?

A

Combination of synthetic progesterone and Ethinyl Estradiol

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2
Q

Describe the regime of the combined oral contraceptive pill

A

Taken for daily for 21 days with a pill free week

Or can use for 3 months continuously and then pill free week

Takes 7 days to switch off ovaries

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3
Q

What is the mode of action of the combined oral contraceptive?

A

Inhibits ovulation

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4
Q

What is the dose of the combined oral contraceptive?

A

20-35mg or 50 if on liver inducers

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5
Q

Give benefits of the combined oral contraceptive pill

A

Regular bleed with potential reduction in pain

Reduction in functional ovarian cysts

Stops ovulation

50% reduction in ovarian and endometrial cancer

Improvement in acne/hirsutism

Reduction in benign breast disease, RA, colon cancer and osteoporosis

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6
Q

Give complications of the combined oral contraceptive pill

A

Breast tenderness

Nausea

Headache

Irregular bleeding for first 3 months

Mood change

Weight gain

VTE

MI/Stroke

Breast cancer

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7
Q

Give contrandications of the combined oral contraceptive pill (and other combined contraception)

A

BMI>35

Smoker>35

Previous VTE

Migraine with aura

Breast feeding

Wheelchair use

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8
Q

What advice is given if a dose of the oral contraceptive pill is missed?

A

If 1 pill missed, at any time in cycle

  • Take two pills in a day and then continue normal regime

If 2 or more pills missed

  • Take two pills in a day, leaving earlier missed pills and continue normal regime
  • If days 1-7, emergency contraception considered if uprotected sex in pill free interval or week 1
  • If days 8-14, no need for emergency contraception if 7 consecutive days of taking pill
  • If days 15-21, finish pills in current pack and start next pack immediately
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9
Q

how long should patients stop the cocp before surgery?

A

4 weeks before

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10
Q

How often does the patch have to be changed?

A

Wear one patch a week for three weeks and do not wear a patch on week 4

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11
Q

What action is required if there is delayed patch change?

A

If over 48 hours, use barrier protectionf or 7 days and emergency contraception if required

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12
Q

How often is the vaginal ring changed?

A

Changed every 3 weeks, can take out for 3 hours in 24 hours so many take out for intercourse

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13
Q

Describe the regime of the progestogen only pill

A

Same time every day, without pill free interval (effect lost if more than 3 hours late)

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14
Q

What is the mode of action of the progestogen only pill?

A

Thickening of cervical mucus

(Desogestrel’s main method is inhibiting ovulation)

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15
Q

Give benefits of the progestogen only pill

A

Amenorrhoea

Useful for those contraindicated using combined pill

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16
Q

Give complications of the progestogen only pill

A

Irregular bleeding, most common adverse effect

>Appetite

Hair loss/gain

Mood change

Bloating/fluid retention

Headache

Acne

Erratic bleeding

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17
Q

Give contraindications of the progestogen only pill

A

Severe liver disease

Current VTE

Hormone dependent tumour

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18
Q

What is the dose of Depo-Povera/injectable progestogen?

A

150mg IM to upper quadrant of buttock

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19
Q

What is depo-provera?

A

An aqueous solution of crystals of the progestogen depomedroxyprogesterone acetate

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20
Q

How often do women have to get depo-provera?

A

Every 12 weeks

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21
Q

What is the mode of action of depo-provera?

A

Inhibits ovulation

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22
Q

Give benefits of depo-provera

A

Good for forgetful pill takers

70% women amenorrhoeic after 3 doses

Estrogen free so few contraindications

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23
Q

Give complications of depo-provera

A

Delay in return to fertility

Reversible reduction in bone density

Problematic bleeding

Weight gain

Not suitable in women over 50

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24
Q

What is the subdermal impant?

A

Progestogen etonogestrel in a matrix of ethinylvinylacetate (EVA)

25
How long does the implant last?
3 years
26
What is the mode of action of the implant?
Primary method is inhibition of ovulation, but also thickening of cervical mucus
27
Give benefits of the implant
Oligomenorrhoea
28
Give complications of the implant
**Irregular menstrual bleeding**, main complication Mood change Delayed return to fertility
29
How long does the copper IUD last?
Lasts 5-10 years depending on the type
30
What is the mode of action of the copper IUD?
Decrease sperm motility and survival (toxic to sperm and prevent implantation)
31
Give benefits of the copper IUD
Hormone free, so most suitable for breast cancer patients Long term
32
Give complications of the copper IUD
May make periods heavier/crampier Ectopic pregnancy Perforation and expulsion PID
33
Give contraindications of the copper IUD
Menorrhagia Copper allergy Uterine abnormalities PID Cervical/endometrial cancer
34
How long does the hormonal IUS last?
Lasts 3-5 years depending on type
35
What is the mode of action of the hormonal IUS?
Primary method is preventing endometrial proliferation Also thickening of cervical mucus
36
Give benefits of the hormonal IUS
Long term Oligomenorrhoea/Amenorrhoea
37
Give complications of the hormonal IUS
Initial irregular bleeding, later followed by light menses or amenorrhoea Ectopic pregnancy Perforation and expulsion PID
38
Give contraindications of the hormonal IUS
\<8-12 weeks after C section Uterine abnormalities PID Cervical/endometrial cancer
39
What is the mode of action of barrier methods?
Prevents sperm transport
40
Give benefits of barrier methods
Protects against STI's
41
Give complications of barrier methods
Diaphragms and caps require the correct size and fitting
42
What is a vasectomy?
Permanent division of vas deferens under local anaesthetic
43
Give compliations of vasectomy
Pain due to sperm granuloma Irreversible Requires semen analysis at 3 months to ensure effective Additional contraception for 2-3 months Bleeding
44
What is fertile sterilization?
Fallopian tubes are blocked, usually Filshie clips applied across tube to block tube lumen
45
Give complicatins of female sterilization
Irreversible Risks associated with surgery: Pain, bleeding and visceral damage Ectopic pregnancy
46
Give contraindications of female sterilization
Uncertainty \>BMI Comorbidities that contraindicate general anaesthetic
47
Give the 3 methods of emergency contraception
Copper IUD Ellaone pill Levonorgestrel pill
48
How long after unprotected sex can the copper IUD be used for emergency contraception?
5 days Or up to 5 days after earliest possible day of ovulation (Take shortest cycle length and subtract 14 to get earliest possible day of ovulation)
49
How long after unprotected sex can the ellapone pill be used for emergency contraception?
Up to 120 hours (5 days)
50
How long after unprotected sex can the levonergestrel pill be used or emergency contraception?
72 hours (3 days)
51
When is the ellaone pill only effective?
Only effective before the release of egg
52
When is levonergestrel pill only effective?
Before the release of an egg
53
What is the most effective emergency contraception?
Copper IUD
54
What is the most effective contraception?
Hormonal IUS
55
How long after giving birth do women not require contraception?
Up to 21 days
56
When is lactational amenorrhoea a reliable form of contraception?
Baby is less than 6 months Amenorrhoeic Breast feeding exclusively
57
Describe the management if individual vomits after taking levonorgestrel
If within 3 hours, take another dose
58
What is the contraception of choice in epileptics?
Injection