Contraception Flashcards
List the common methods of contraception
natural family planning barrier eg condom COCP mini pill Coils - mirena or copper progesterone injection or implant surgery
Eligibility criteria
1 –>4
4 means it is contraindicated
what does 99% effective mean?
average person used it correctly with regular partner for 1 year
1% chance of pregnancy
What types are user dependent?
condoms, pill, family planning
risk factors
breast cancer
cervical or endometrial cancer - avoid coil
wilsons disease - avoid copper coil
risk factors COCP
uncontrolled hypertension migraine with aura history of VTE smoking vascular disease SLE history of breast cancer
older women
after last period need contraception for 2 years
HRT does not prevent pregnancy
COCP until 50years
injection stopped before 50 - osteoporosis
When should amenorrhoeic women taking mini pill stop?
FSH blood test above 30
55 years old
under 20yrs
implant is a good choice for LARC
coils - risk of expulsion
injection - osteoporosis
after childbirth
needed 22 days after birth
lactational amenorrhoea is 98% effective until 6 months
COCP avoided in breastfeeding
mini pill or implant safe with breastfeeding
Most effective emergency contraception
IUD
When can an emergency IUD be used?
up to five days after sex or up to five days after earliest time you could have ovulated
emergency contraceptive pill (active ingredient)
ulipristal acetate
120 hours after sex
or levonorgestrel up to 72 hours after sex
How does contraceptive injection work?
release progesterone to stop ovulation and thicken cervical mucus
Name some contraceptive injections
Depo-Provera
sayana press
noristerat
How long do contraceptive injections last?
depo and sayana press = 13 weeks
noristerat = 8 weeks
disadvantages of injection
periods and infertility take time to return after stopping
weight gain
risk of low bine mineral density
Implant
fitted in arm under LA - lasts 3 years
periods may be irregular, stop or last longer
should be able to feel under skin
release progesterone
IUS
Mirena - lasts 3-5 years
can make periods, shorter and lighter and less painful
check for threads
risks with IUS
irregular bleeding
infection up to 20 days after insertion
ovarian cysts
What cancers does COCP reduce the risk of?
colon, ovary and uterus
Who is COCP not suitable for?
overweight or smoker >35 years
Temporary side effects of the COCP
nausea, mood changes, breast tenderness
What can make the pill less effective?
antibiotics, diarrhoea and vomiting, missed pills
when is the progesterone only pill not effective?
taken more then 3 hours late
