Contraception Flashcards
What are the 3 types of combined oral contraceptives?
- Monophasic-
Fixed amount of oestrogen and progesterone for. 21 days. Placebo for the 7 days thereafter - Biphasic
-oestrogen content stays the same but the progesterone increases in the last 10 days - Triphasic
-imitates the normal hormonal cycle
-initially both oestrogen and progesterone is increased and then at the end progesterone is increased and oestrogen decreased
Regarding break through bleeding what can you tell me?
It can occur spontaneously in the first 3 months and it is usually due to insufficient oestrogen
-if its in the 2nd half the cause is insufficient progesterone
What should we do if the patient experiences amenorrhea for more than 6 months on the pill?
Stop the pill and investigate the cause
When do we stop the pill?
At 50 in patients with no risk factors and at 35 years if they smoke or have HPT
We then do an FSH after 7 days and if it is raised to post-menopausal levels we can start the patient on HRT’
-if it is not raised then start the patient on barrier contraceptives
What should patients with hirsuitism and acne take?
Diane because it has increased oestrogen and has an anti-androgen
What is the definition of a missed pill?
If more than 24 hours have passed since the last pill
What is the definition of a late pill?
If it wasn’t taken at the usual time
If a patient presents with 1 missed active/hormonal pill, what should she do?
Immediately take the pill with the second days one too
What are the advantages of using the copper T intra-uterine device?
- Very effective
- Works as emergency contraceptive
- Works immediately
- When taken out the woman can fall pregnant easily
- Cost effective
- Can be used by all women-nulliparous and HIV positive
What is the mechanism of action of the copper IUCD?
- It prevents fertilisation by impairing the sperm motility
- Causes inflammation of the endometrium to make implantation unfavourable
