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Primary Care > Contraception > Flashcards

Contraception Flashcards

1
Q

What are the main types of contraception?

A 
COCP 
POP
Progesterone implant
Progesterone patch 
IUD
IUS
Condoms
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2
Q

What does the COCP contain?

A

Oestrogen + progesterone

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3
Q

How is the COCP taken?

A

21 days on
7 days off

Take 1 pill a day at a similar time

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4
Q

What is the effect of the COCP?

A

Inhibits ovulation
Inhibits follicular development
Thickens cervical mucus

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5
Q

What are contraindications for the COCP

A 
BMI >35 + >15 cigarettes/day
FHx of VTE <45y
HYpertension 
Immobility 
History of VTE
Migraine with aura
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6
Q

What are benefits of the COCP?

A

Improve acne
Reduce menstrual symptoms
Reduce risk of endometrial + ovarian cancer

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7
Q

Does any additional contraception need to be used when the COCP is started?

A

If after day 5 - use 7 days of barrier protection

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8
Q

What are the risks of the COCP?

A

No STI protection
VTE
Mood changes

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9
Q

What happens if you miss one COCP?

A

Take it ASAP - even if 2 in one day

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10
Q

What happens if you miss 2 or more COCP?

A

Take 1 ASAP - even if 2 in one day
Use alternative contraception for 7 days

If in last 7 days - do not take break

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11
Q

What does the POP contain?

A

Progesterone

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12
Q

How is the POP taken?

A

Taken daily - similar time each day

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13
Q

What is the effect of the POP?

A

Thickens cervical mucus

Reduces motility of fallopian tubes

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14
Q

Does any additional contraception need to be used when the POP is started?

A

If after day 5 - use 2 days of barrier contraception

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15
Q

What are contraindication for the POP?

A

Current breast cancer
Liver disease
Ischaemic heart disease

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16
Q

Who can use the POP?

A 
Older women 
Heavy smokers
VTE history 
HTN 
Breastfeeding women
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17
Q

What are the side effects of the POP?

A 
Menstrual irregularities 
Increased risk of ectopic pregnancy 
Mood changes
Acne
Weight gain
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18
Q

What happens if you take the POP <3 hours late?

A

Continue as normal

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19
Q

What happens if you take the POP >3 hours late?

A

Continue and use 2 days barrier contraception

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20
Q

What does the patch contain?

A

Oestrogen + progesterone

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21
Q

How is the patch used?

A

3 patches - one per week

1 week patch free

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22
Q

What is the effect of the patch?

A

Inhibits ovulation

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23
Q

What is a benefit of the patch?

A

Can make periods lighter

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24
Q

What are negatives of the patch?

A

Skin irritation

Visible

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25
Q

What happens if you miss a patch in week 1 or 2?

A

<48 hours

  • change immediately
  • continue as normal

> 48 hours

  • change immediately
  • use barrier method for 7 days
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26
Q

What happens if you delay the start of the patch?

A

Use a barrier method for 7 days

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27
Q

What happens if you delay the removal in week 3?

A

Remove ASAP

Continue as normal

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28
Q

What does the injection contain?

A

Progesterone

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29
Q

How is the injection given?

A

IM injection every 12 weeks

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30
Q

What is the fertility return like with the injection?

A

Can take up to a year

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31
Q

What is the effect of the injection?

A

Inhibits ovulation

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32
Q

What are the advantages of the injection?

A

Reduces risk of ectopic pregnancy
Reduces risk of endometrial cancer
Safe for breast feeding

33
Q

What are disadvantages of the injection?

A

Irregular bleeding
Weight gain (3kg/year)
Reduces bone density

34
Q

What does the implant contain?

A

Progesterone

35
Q

What is the effect of the implant?

A

Inhibits ovulation

36
Q

How is the implant used?

A

Small procedure to insert

If inserted after day 5 - use barrier method for 7 days

37
Q

What are contraindications for use of the implant?

A 
Current breast cancer
Liver disease
Stroke 
Ischaemic heart disease
Hepatic enzyme inducing drugs
38
Q

How long does the implant last?

A

3 years

39
Q

What is the return to fertility like after using the implant?

A

Returns immediately

40
Q

What are side effects of the implant?

A

Irregular/heavy bleeding
Nausea
Headache
Breast pain

41
Q

What does the IUS contain?

A

Progesterone

42
Q

What is the effect of the IUS?

A

Prevents endometrial proliferation

Thickens cervical mucus

43
Q

How long does the IUS last?

A

5 years

44
Q

Who can use the IUS?

A

Migraine sufferers
Obese patients
On hepatic enzyme inducing drugs

45
Q

What are the uses for the IUS?

A

Contraception
Menorrhagia
Prevention of endometrial hyperplasia in oestrogen therapy

46
Q

What are the contraindications for the IUS?

A

Pregnancy
STI
Gynae cancer
Anticoagulation problem

47
Q

What are the side effects of the IUS?

A

Change in bleeding - usually lighter
Mastalgia
Mood changes

48
Q

What does the IUD contain?

A

Copper

49
Q

What is the effect of the IUD?

A

Reduces sperm motility

Prevents implantation

50
Q

How long does the IUD last?

A

5-10 years

51
Q

What are contraindications for the IUD?

A

Copper allergy
Heavy periods
Wilson’s disease

52
Q

What are the uses for the IUD?

A

Older women
2nd line in younger women
Emergency contraception

53
Q

What are side effects of the IUD?

A

Heavier periods

54
Q

How long after UPSI can the IUD be used?

A

120 hours

55
Q

What is the only contraception that protects against STIs?

A

Barrier methods

  • condom
  • cap
56
Q

What are permanent contraception options?

A

Sterilisation

57
Q

What is female sterilisation called?

A

Tubal ligation

58
Q

What is the failure rate for female sterilisation?

A

1 in 2000

59
Q

How is female sterilisation done?

A

Under GA - cut + tie fallopian tubes

60
Q

What contraception needs to be used alongside female sterilisation?

A

Other method until 1st period

61
Q

What is male sterilisation called?

A

Vasectomy

62
Q

What is the failure rate for male sterilisation?

A

1 in 200

63
Q

How is male sterilisation done?

A

Under LA - vas deferens cut and tied

64
Q

How long until a vasectomy works?

A

Up to 8 weeks

Need 2 sperm samples showing azoospermia

65
Q

What are options for emergency contraception?

A

Ulipristal acetate
Levonorgestrel
IUD

66
Q

What is the brand name for ulipristal acetate?

A

Ellaone

67
Q

What is the effect of ulipristal acetate?

A

Inhibits ovulation

68
Q

How long after the UPSI can ulipristal acetate be used?

A

Up to 120 hours

69
Q

What condition in ulipristal acetate contraindicated in?

A

Severe asthma

70
Q

Can ulipristal acetate be used more than once per cycle?

A

No

71
Q

What do you need to do with normal contraception after use of ulipristal acetate?

A

5 days off of hormonal contraception

72
Q

What is the effect of levonorgestrel?

A

Inhibits ovulation

73
Q

How long after the UPSI can levonorgestrel be used?

A

Up to 72 hours

74
Q

Can levonorgesrel be used more than once a cycle?

A

Yes

75
Q

When do you double the dose of levonorgestrel?

A

> 70kg

> BMI 35

76
Q

What do you need to ensure when prescribing to a child?

A

Gillick competence

77
Q

What needs to be fulfilled for Gillick competence?

A
  1. able to understand implications of treatment
  2. cannot be persuaded to tell parents
  3. likely to be sexually active with or without contraception
  4. is likely to suffer if no contraception given
  5. is in the best interest
78
Q

What guideline is used when giving contraception?

A

UKMEC guidelines

Primary Care (31 decks)

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