Contraception Flashcards
What are the three methods of combined hormonal contraception
Tablets patches and rings
What age is too old for the combined contraception
50
Name 7 health benefits of Combined hormones contraception
Reduced risk of ovarian endometrial and colorectal cancer
Predictable bleeding patterns
Reduced dysmenorrhea and menorrhagia
Management of symptoms of PCOS endometriosis and premenstrual syndrome
Improves acne
Reduced menopausal symptoms
Maintaining bone mineral density in perimenopausal females under 50yo
What does the term monophonic and multiphase mean in relation to combined contraception
Monophasic - fixed amount of oestrogen and progesterone
Multiphasic - varying amounts of the two hormones
What is the general dose of ethinylestradiol in the first line pill in combination with what type of progesterone
Monphasic 30micrograms in combination with levonorgestrel or norethisterone
Ethinylestradiol is in … units
Micro grams
Estradiol is in what units
Mg
What are alternative ways to use the pill in terms of hormone free intervals
21 days in 4 days off
9 weeks on 4-7 days off
21 days on then 4 days off when breakthrough bleeding occurs
Continuous use with no hormone free days
What should be checked annually on the pill
BP and BMI
When should the pill be stopped and recommenced with surgery
Stop 4 weeks prior
Continue two weeks after
How do oral progestogen only preparations work
Alter cervical mucous to prevent spleen penetration and may inhibit ovulation
How do desogesterel only preps work
Inhibit ovulation
What is the main reason for giving progesterone over combined pill
When oestrogen is contraindicated
What is the medical name for Depo
Medroxyprogesterone acetate
What may occur after discontinuation of depo
Delayed return of fertility and irregular cycles
How long does it take for fertility to return after depo
3-6 months but can take up to a year
Is the implant combined or progesterone
Progesterone
How long does the implant work for
3 years
IUS is
Progesterone only - levonorgestrel
IUS how long does it take for fertility to return
Rapid
Contraindications to combined contraceptives
Heart disease breast cancer hepatocellular carcinoma Known thrombophlebitis mutations Less than 6 weeks postpartum Migraine with aura Previous or current VTE Stroke /TIA PVD Smoking aged >35 SLE Be cautious with BRCA mutation BMI>35 Cervical neoplasia
Side effects of combined pills
Acne fluid retention weight gain headaches irregular bleeding nausea
Which cancers does the pill increase the risk of
Breast
Cervical
When does the risk of breast cancer diminish after the use of cocp
Disappears after 10 years of using the pill
When do you get an increase in risk of cervical cancer
If using for longer than 5 years
Diminishes after 10 years
Can you use cocp while breast feeding
Avoid until weaning or for 6 months after birth
When can you start the pill after giving birth
3 weeks or 6 weeks with risk factors
When can you start taking the pill
If starting on day six or later you need barrier protection for the first 7 days
When is the critical time for loss of contraceptive protection
When a pill is omitted at the beginning or end of a cycle (which lengthens the pill free interval)
If a woman misses a pill she should take it ….. and the next one taken …..
As soon as possible ….. taken at normal time even if it means taking two together
When does a pill count as missed
If greater than 24 hours or later
If 2 or more missed particularly in the first seven days …..
Barrier protection
If two or more missed and barrier protection used for 7 days but the 7 days end up running beyond the end of the packet
Take the next packet immediately and don’t take a break
What is the main contraindication for progesterone only pill
Acute porphyria
Breast cancer
What is a suitable alternative contraception prior to surgery
Progesterone only pill
