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Gynaecology > Contraception > Flashcards

Contraception Flashcards

1
Q

Which methods of contraception are classed as combined hormonal contraception?

A
  • COCP
  • Transdermal patch
  • Vaginal ring
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2
Q

Describe the primary mechanism of action of the combined oral contraceptive pill

A

Inhibits ovulation

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3
Q

Describe the primary mechanism of action of…

a) Progesterone-only pill (excluding desogestrel)
b) Desogestrel

A

a) Thickens cervical mucus

b) Inhibits ovulation

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4
Q

Which methods of contraception are classed as progesterone-only hormonal contraception?

A
  • POP
  • Implant
  • Injection
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5
Q

How long does the contraceptive implant (Nexplanon) last?

A

3 years

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6
Q

Give a potential side effect of the contraceptive injection

A

Weight gain

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7
Q

What is the IUD (intrauterine device)?

A

Copper coil

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8
Q

What is the IUS (intrauterine system)?

A

Hormonal coil, e.g. Mirena

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9
Q

Describe the mechanism of action of the IUD

A

Releases copper, which decreases sperm motility and survival

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10
Q

Describe the primary mechanism of action of the IUS

A

Inhibits endometrial proliferation

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11
Q

When can the IUD be fitted during the menstrual cycle?

A
  • Can be fitted anytime during the menstrual cycle

- Provides contraception IMMEDIATELY

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12
Q

When can the IUS be fitted during the menstrual cycle?

A
  • Can be fitted anytime during the menstrual cycle
  • Only effective immediately if fitted within the first 7 days of the menstrual cycle (otherwise, additional contraception is required for 7 days)
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13
Q

Other than use as a regular contraceptive, does the IUD have any other uses?

A
  • Emergency contraception (effective if fitted within 5 days of UPSI)
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14
Q

How long does the IUD last?

A

5-10 years (depending on the type)

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15
Q

Which contraceptives can be taken while breastfeeding?

A
  • Progesterone-only contraceptive pill
  • Implant
  • Injection
  • IUD/IUS

*COCP is contraindicated up to 6 weeks postpartum, but can be prescribed after 6 weeks postpartum, even while breastfeeding

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16
Q

What are the different types of emergency contraception available?

A
  • ‘Morning after pill’ (Levonorgestrel or Ulipristal acetate, also known as EllaOne)
  • IUD
17
Q

Describe the mechanism of action of the ‘morning after pill’ (both types)

A

Delays ovulation by 5-7 days, after which sperm will have become non-viable

18
Q

Levonorgestrel is licensed for use within … hours of UPSI

A

72 hours of UPSI

19
Q

EllaOne is licensed for use within … hours of UPSI

A

120 hours of UPSI

20
Q

Give an example of a situation when the morning after pill may not work

A

Vomiting shortly after taking emergency contraception

21
Q

Is contraception required immediately after giving birth - if not, how long is contraception NOT required for?

A
  • No
  • In non-breastfeeding women, ovulation can occur as early as day 28, therefore contraceptive protection is required from day 21 onwards
22
Q

What are the risks of the combined oral contraceptive pill with regards to women’s cancers?

A

Combined oral contraceptive pill:

  • Protective against ovarian and endometrial cancer
  • Increased risk of breast and cervical cancer
23
Q

If not started on day 1 of cycle, when do the following forms of contraception become effective?

  • IUD
  • POP
  • COCP
  • Implant
  • Injection
  • IUS
A
  • IUD = immediately
  • POP = 2 days
  • COCP, implant, injection, IUS = 7 days
24
Q

A woman who is taking the COCP presents to her GP having missed 1 pill. What do you advise her?

A

If 1 pill is missed (at any time in the cycle):

  • Take the last pill even if it means taking two pills in one day
  • Continue with the rest of the pack
  • No additional contraceptive protection needed
25
Q

A woman who is taking the COCP presents to her GP having missed 2 pills. What would you advise her if this happened during…

a) Week 1
b) Week 2
c) Week 3

A

If 2 or more pills missed:

  • Take the last pill even if it means taking two pills in one day (leave any earlier missed pills)
  • Continue with the rest of the pack
  • Use condoms or abstain from sex until she has taken pills for 7 days in a row

a) Emergency contraception required
b) No additional measures
c) Omit next pill free interval

Gynaecology (8 decks)

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