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PM Important > Contraception > Flashcards

Contraception Flashcards

1
Q

What is the COCP protective against?

A
  • ovarian and endometrial cancer
  • colorectal cancer
  • PID
  • reduces ovarian cysts, benign breast disease, acne vulgaris
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2
Q

What does the COCP increase the risk of?

A
  • no protection against STI
  • VTE
  • breast and cervical cancer
  • stroke and ischaemic heart disease
  • temporary side effects: headache, nausea, breast tenderness
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3
Q

UKMEC 3 conditions contraindicating COCP:

disadvantages outweigh advantages

A

->35yo and smoking less than 15 cigarettes/day
-BMI >35kg/m2
-FHx of thromboembolic disease in first degree relatives <45 years
-controlled HTN
-immobility e.g. wheel chair
-known gene mutations associated with breast cancer
-current gallbladder disease
(diabetes)

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4
Q

UKMEC 4 conditions contraindicating COCP: (unacceptable health risk)

A

-more than 35yo and smoking more than 15 cigarettes/day
-migraine with aura
-history of thromboembolic disease or thrombogenic mutation
-history stroke or ischaemic heart disease
-breast feeding <6weeks post-partum
-uncontrolled HTN
-current breast cancer
-major surgery with prolonged immobilisation
(diabetes)

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5
Q

COCP MOA:

A

inhibits ovulation

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6
Q

POP MOA:

A

thickens cervical mucus

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7
Q

Injectable contraceptive (medroxyprogesterone acetate) MOA:

A
  • primary: inhibits ovulation

- also: thickens cervical mucus

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8
Q

Implantable contraceptive (etonogestrel) MOA:

A
  • primary: inhibits ovulation

- also: thickens cervical mucus

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9
Q

Intrauterine contraceptive device MOA:

A

decreases sperm motility and survival

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10
Q

Intrauterine system (levonorgestrel) MOA:

A
  • primary: prevents endometrial proliferation

- also: thickens cervical mucus

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11
Q

Ullipristal MOA and use as emergency contraception:

A
  • selective progesterone receptor modulator (EllaOne)
  • emergency contraception
  • inhibits ovulation
  • 30mg asap no later than 120 hours
  • not with levonorgestrel
  • can be used more than once in same cycle
  • care with asthma
  • breastfeeding delayed one week after
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12
Q

Use of levonorgestrel as emergency contraception:

A
  • emergency contraception
  • efficacy decreases with time
  • within 72 hours of unprotected SI
  • single dose 1.5mg (progesterone)
  • double dose if BMI>26
  • 84% effective
  • repeat dose if vomiting within 3 hours
  • can be used more than once in menstrual cycle
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13
Q

Use of intrauterine device as emergency contraception:

A
  • can be inserted within 5 days of UPSI
  • IUD may be fitted up to 5 days after likely ovulation date
  • inhibits fertilisation or implantation
  • 99% effective
  • may be left in situ
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14
Q

What is the most effective form of contraception?

A

implantable contraceptives

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15
Q

How long can implantable contraceptives last?

A

3 years

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16
Q

ADR implantable contraceptives:

A
  • irregular heavy bleeding
  • can co-prescribed COCP
  • progesterogen effects: headache, nausea, breast pain
17
Q

Fertility with injectable contraceptives:

A

can have delay in return to fertility up to 12 months

18
Q

ADR injectable contraceptives:

A
  • irregular bleeding
  • weight gain
  • may increase risk of osteoporosis
  • not quickly reversible and fertility
19
Q

Contraindications injectable contraceptives:

A

breast cancer

20
Q

Types of intrauterine contraceptive devices:

A

IUD - copper intrauterine devices

IUS - mirena, levonorgestrel releasing intrauterine systems (also used to manage menorrhagia)

21
Q

IUD MOA:

A
  • prevents fertilisation by decreasing sperm motility and survival
  • works immediately
  • effective for 5-10 years
22
Q

IUS MOA:

A
  • works after 7 days

- most common effective for 5 years

23
Q

IUS ARD:

A
  • longer, heavier more painful periods
  • uterine perforation 2 in 1000
  • expulsion 1 in 20 in first 3 months
  • small increased risk infection
24
Q

POP ADR:

A

irregular vaginal bleeding

PM Important (16 decks)

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