Contraception consultation Flashcards
what to ask at the start of the consultation?
- why is it that you’re needing contraception, are you using something currently?
- tell me about your boyfriend….sexual abuse?
- if they ask about specific type of contraception…. what made you think that would be a good idea?
what are the 4 main methods of contraception?
- pills
- injections
- IUD
- implant
what risk factor questions should you ask before offering the pill?
Migraine with aura
Hx of VTE
BMI > 35
Age > 50, or age > 35 if smoker (>15 per day)
Many CV risk factors eg smoking, hypertension, DM, hyperlipidaemia
what is the reason you cant have the cocp if you suffer with migraine with aura?
- slightly increases the risk of ischaemic stroke
what is important safety netting you have to do before giving the pill?
Stop pill and see doctor if calf pain or swelling, chest pain or SOB
what is a good order for hx
pc- why they want contraception, (safeguarding), why a particular type of contraception
gynea hx- regular period, sti risk, smear test up to date, and hx of contraception with any side effects- are you a good pill taker?
pregnancy hx
risk assessment- ‘first of all i need to assess if you will be suitable for the pill- this will involve some questions then i will take your bp’
migraine, VTE, smoking, age
PMH- acne
dhx- avoid st john wort
fhx- VTE
what should you say before talking about how to take the pill?
- im going to talk about quite a lot to you now, so i will give you a leaflet with the information in case you need to remind yourself of what we’ve covered here today
when should you start cocp?
- best to start on the 1st day of period, between day 1-5 it will give protection straight away
- if switching from another form of contraception make sure to cover yourself with an additional form of contraception since it will take 7 days to kick in
how many days should you take cocp?
- each pack have 21 pills in it
- take a pill a day for 3 weeks at the same time each day then have a 7 day break before starting your new pack
- in the in between time you will have a period
what examinations should you do before talking about how to take the pill?
- bp
- bmi
what to do about missed pills?
- missing 1 pill is still okay
- missing 2 pills will mean it wont work for the next 7 days so use extra protection during that time
- if you miss 2 pills in the last week of a pack then run 2 packs straight one after the other and dont have a break- you wont have a period, or it may only be light
- if you miss 2 pills in the first week of a pack it may mean that you were unprotected in the time preceding the pill- in which case you can contact us or seek medical advice
what to do if d&v with cocp?
- if less than 3 hours after taking pill, take another
- if vomiting or diarrhoea continues for over 24hrs, count each day with D+V as a day that you have missed the pill
- make sure to use protection whilst unwell and in the 7 days after
when should you have a follow up?
in 3 months
