Contraception Flashcards
What are the circumstances around breastfeeding being an effective contraception
if a woman is <6 months post-partum, amenorrhoeic and regularly breastfeeding there is a 98% effectiveness
when is emergency contraception required in the period after pregnancy
21 days+ you consider it, <21 days it is not required
what is the advice around the COCP with breastfeeding
avoid within first 6 months as affects breast milk volume
when can you start progesterone only contraception post partum
6 weeks
when can the IUD be inserted post partum
4 weeks
how should you deal with contraception in the perimenopausal stage
<50 stay on contraception for at least 2 years after LMP
>50 same but 1 year
how does the COCP act as contraception
Exerts a negative feedback loop on gonadotrophin causing ovulation to cease
Thin the endometrium and thicken cervical mucus
what is the regular regime for the COCP
take for 3/52 then skip for 1/52
what may occur if the COCP is taken back to back with no gaps
not much but some light spotting may occur
what is the success rate for the COCP with a proper usage
99.8%
what are some uses outside of contraception for the COCP
Menstrual cycle control in primary dysmenorrhoea
Menorrhagia
Endometriosis protection
Recurrent simple ovarian cysts
Acne
PMS
Reduces risk of PID
Reduced risk of bowel/endometrial/ovarian CA)
what factors affect the absorption of the COCP
diarrhoea
vomiting
oral Abx
what is the standard advice for missing 1-2 doses of the COCP, or 1 of the reduced dose pill
1-2 doses is fine, and 1 of the reduced one is fine, but any more and it should be a concern. if this happens you should use condoms for 7 days
what are the major complications for the COCP and how rare are they
Venous thrombosis
Myocardial infarction
Cerebrovascular accidents
Focal migraine
Hypertension
Jaundice
Liver,breast,cervical carcinoma
2-5 per million excess deaths per year in <35
what are some side effects of the COCP
Nausea
Breakthrough bleeding
Suppressed lactation
Contraindicated <6 weeks post partum
Headache
Breast tenderness
what are some absoloute contraindications of the COCP
Clotting disorders (e.g factor V leidans)
> 35 years old smoking >15 day
Migraine with aura
Personal history of thrombotic disease
History of stroke or ischaemic disease
Breast feeding
Uncontrolled hypertension (Syst >160,Diast >95)
Current breast cancer
Major surgery with prolonged immobility
Any hepatic disorders
Any nephropathy
Any neuropathy
Uncontrolled diabetes
what is the combined transdermal patch
delivers oestrogen and progesterone
how is the combined transdermal patch delivered
same as COCP, put on for 3 weeks and take off for a week
how does the combined vaginal ring work
latest ring the releases synthetic oestrogen and progesterone
how is the combined vaginal ring administered
same as COCP/patch, put in for 3 weeks and taken out for a week
should the combined vaginal ring be removed for intercourse
no
what is the maximum the combined vaginal ring can be removed for
3 hours