Contraception Flashcards

1
Q

contraception mechanisms of action

A
  1. prevention of ovulation
  2. prevention of fertilisation
  3. prevention of implantation
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2
Q

how can contraception prevent ovulation?

A

suppress FSH and LH

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3
Q

how can fertilisation be prevented?

A

no contact e.g. condoms, diaphragm, sterilisation, IUD

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4
Q

how can implantation be prevented?

A

create hostile environment

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5
Q

classification of contraception

A
hormonal methods
barrier methods
intrauterine methods
permanent methods
fertility awareness methods
emergency
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6
Q

non-contraceptive benefits of contraception

A
pain
heavy bleeding
irregular bleeding
PMS
breast tenderness
acne hirsutism
ovarian cancer
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7
Q

what cancer does contraception protect against?

A

ovarian

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8
Q

LARC methods

A
  1. IUD/IUS

2. implant

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9
Q

consequences of using IUD/IUS

A

painful insertion
perforation
malposition
expulsion

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10
Q

when can IUD/IUS not be used?

A

submucosal fibroids

uterine malformations

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11
Q

how long does the IUD last?

A

up to 10 years

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12
Q

action of IUD

A

non-hormonal but prevents implantation

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13
Q

when can IUD be used as emergency contraception?

A

up to 5 days after sex

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14
Q

adverse of the IUD (copper coil)

A

makes period heavy, longer and more painful in first few months (can co-prescribe NSAIDs)

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15
Q

which method of contraception is the only option after breast cancer?

A

IUD

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16
Q

is the IUS hormonal?

A

yes

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17
Q

what are the types of IUS?

A

mirena
levosert
kyleena
jaydees

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18
Q

what is mirena also licensed to treat alongside contraception?

A

heavy periods

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19
Q

adverse of IUS

A

irregular spotting

PV bleeding in first few months then leads to amenorrhoea around 6 months

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20
Q

what is the most effective method of contraception?

A

implant

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21
Q

how long does the implant last?

A

3 years

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22
Q

how does the implant work

A

hormonal (progestogen only)

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23
Q

side effects of implant

A

invasive procedure with LA

prolonged PV bleeding

24
Q

what is the criteria used for contraception use?

A

UKMEC

25
Q

examples of combined hormonal contraception

A

OCP
ring
patch

26
Q

when to start OCP

A

first 5 days of period OR anytime in cycle if sure not pregnant and use condoms for 7 days

27
Q

how should the OCP be taken?

A

21 days then 7 day break (can do tricycling)

28
Q

what factors affect the effectiveness of the OCP?

A
impaired absorption (GI conditions)
increased metabolism (liver)
forgetting
29
Q

adverse of CHC

A
nausea 
acne
bleeding
breast tenderness
venous and arterial thrombosis
breast cancer and cervical cancer (always discuss condoms and smear)
hypertension
arterial disease
30
Q

what to always discuss when prescribing contraception?

A

smear

CONDOMS

31
Q

what cancers does the CHC increase the chance of?

A

breast cancer

32
Q

what do migraines with aura risk when on CHC?

A

ischaemic stroke

33
Q

what is an aura?

A

a change occurring 5-20 minutes before onset of headache (usually visual e.g. scotoma)

34
Q

what do you need to check before prescribing the CHC?

A

BP
BMI
smear
other RF (VTE)

35
Q

additional benefits of OCP

A
ovarian and endometrial cancer
acne reduction
less bleeding
less cysts
less PMS
PCOS
36
Q

what cancers do the OCP protect against?

A

ovarian

endometrial

37
Q

what is the POP called?

A

cerelle (desogestrel)

38
Q

action of POP

A

inhibits ovulation

39
Q

when do you start the POP?

A

begin in first 5 days of period or anytime if sure not pregnant and use condoms for 2 days

40
Q

when do you take the POP

A

same time everyday (within 12 hours)

41
Q

what to do if miss POP?

A

doesn’t work for 2 days

take pill as soon as realise and use condoms for 2 days (or 7 days in OCP)

42
Q

is the POP contraindicated in breast cancer?

A

yes

43
Q

common adverse of POP

A

irregular bleeding

44
Q

two forms on the injection?

A
depo provera (DMPA injection)
sayana press (self-administered)
45
Q

action of injection

A

prevents ovulation lowering oestradiol and suppresses FSH

46
Q

when can the injection not be used?

A

OP risk factors

good in epilepsy

47
Q

adverse of injection

A
nausea
weight gain
acne
headache
bleeding
limits peak bone mass
48
Q

how to use the diaphragm?

A

remove and wash before using again

no longer really used

49
Q

three options for emergency contraception

A
  1. copper coil
  2. ellaOne
  3. levonelle
50
Q

when can levonelle be used

A

within 72 hours (3 days)

51
Q

when can ellaone be used?

A

within 120 hours (5 days)

52
Q

when can ellaOne not be used?

A

progesterone contraception

53
Q

action of emergency morning after pills

A

delays ovulation

54
Q

action of copper coil

A

toxic so prevents implantation

55
Q

male sterilisation

A

vasectomy