Contraception Flashcards
what is LARC
long acting reversible contraception
what are the main types of LARC available
IUD
IUS
implant
what are the main types of non-LARC available
contraceptive pills
barrier methods such as condoms, rings and diaphragm
injection
sterilisation
list the difference mechanisms of action contraception methods have
prevent ovulation by suppressing LH and FSH
prevention of fertilisation by toxicity
prevention of implantation by increasing mucus and making the endometrium hostile
list the non-contraceptive benefits of hormonal contraception
reduce all of: heavy bleeding irregular bleeding PMS ovarian cysts ovarian/endometrial cancer acne and hirsutism if on CHC
which methods have a lower failure rate, LARC or non-LARC
LARC as the difference between the best and most common way to take it is very small. non-LARC has more chance of error
what are the contraindications for IUD/IUS
submucosal fibroids
uterine malformation
any other uterine pathology
which type of IUD/IUS is non-hormonal and what is a dis-advantage to it
copper coil is non-hormonal
disadvantage can make periods heavier and more painful in first few months
what are some risks associated with insertion of IUS/IUD
small risk of perforation and expulsion following insertion
what are the 4 different types of IUS
marina
levosert
kyleena
jaydess
what non-contraceptive benefit does the Marina coil have
licensed to treat heavy bleeding and help with heavy periods. 50% have amenorrhoea 6 months after insertion
what is the depo provera
contraceptive injection which is a progestogen only method
what are the contraindications of the deop provera
very few except known breast or gynaecological malignancy
what is the main side effect of the depo provera
prolonged PV bleeding - unpredictable
weight gain
homonal s/e such as nausea, spots, headaches
what are the three methods of combined hormonal contraception
pill
patch
ring
describe the cycle of taking the COCP
take 1 pill for 21 days then have 7 day break for withdrawal bleed then repeat. can run up to three packs together before stopping for bleed
when is it safe to begin the COCP
can begin it within first 5 days of period and immediately protected or any other time throughout cycle and use other method of contraception for 7 days
what factors can affect the effectiveness of COCP
impaired absorption eg GI conditions
increased metabolism such as liver enzyme inducers eg Carbamazepine
forgetting to take pill
list some of the main risks of CHC
venous thrombosis
hypertension -> MI and stroke if high risk
increased breast cancer risk
list the main side effects of CHC
nausea
spots
breast tenderness
bleeding
list the main contraindications of CHC
smoking
BMI >30
>40 years old
Hx of VTE, stroke, AF
COCP is protective against which cancers
ovarian, endometrial and cervical due to switching off of ovulation
how does POP work
thickens cervical mucus to inhibit implantation
hoe does COCP work
prevent follicular development which inhibits ovulation
what are the contraindications to POP
breast cancer in last 5 years
liver disease
when can you start using POP
within first 5 days of period, immediately protected or any other time of cycle and use condoms for 2 days
what is the routine of taking POP
take 1 pill every day at the same time for 3 weeks, if forget within 12 hours unprotected for 2 days, 1 week off to bleed
what type of drugs can interact with COCP and POP
liver enzyme inducers making pill ineffective
what is nexplanon
a progestogen only implant rod that offers contraception for 3 years
does the depo provera interact with liver enzyme inducers
no - therefore best method in women with epilepsy
what is one of the risks of using the depo in teenage girls as a contraceptive method
reduced bone density and this can result in overall lower peak bone density -> risk of osteoporosis
what are the side effects of the implant
hormonal side effects
changes in bleeding - some can have amenorrhoea
list the 3 methods of emergency contraception
copper IUD
ellaOne
Levonelle
which is the most effective method of emergency contraception
copper IUD
what criteria must be met to have a copper IUD fitted in an emergency
within first 5 days of period
or within 5 days of single episode of sex
what is the mechanism of action of ellaOne
blocks progestogen receptors, stops LH surge which suppresses ovulation
how many days can ellaOne be taken after intercourse
up to 5 days after but most effective asap
what is the mechanism of action of Levonelle
high dose of progestogen, aims to inhibit ovulation
how many days can levonelle be taken after intercourse
3 days but take asap
when is levonelle less effective in a womens cycle
towards the end of the cycle if already ovulated
both oral methods of emergency contraception are affected by liver enzyme inducers true/false
true
