Extra Extra Contraception Stuff Flashcards
How do bleeding patterns vary with an IUD or an IUS?
IUD- heavy regular bleeding
IUS - light irregular bleeding, eventual amenorrhea in some cases
What are the contraindications to fitting an IUD/IUS?
Pregnancy Undiagnosed bleeding Cervical/uterine cancer pre treatment Active PID or in last three months Current chlamydia, gonorrhoea Uterine abnormality Gestational trophoblastic disease
What is the risk of expulsion in an IUD/IUS and when is it most common?
One in twenty
Most common in first three months after fitting and with heavy menstruation
Expulsion more noticeable with an IUS as hormonal effects wear off and periods start again
What is the risk of perforation with an IUD/IUS and when is it most common?
One in a thousand
Most common in early post natal period in lactating women
What is the failure rate of the IUD as emergency contraception?
Less than one in a thousand
When can the IUD be used as emergency contraception?
Within five days of risk or ovulation
Not after day 19 in a 28 day cycle unless only one risk within five days
If referring on, give oral emergency contraception
How long after the risky sexual encounter may ullipristal be used as EC?
Up to five days after
Enzyme inducers may reduce efficacy, not recommended for women with severe asthma
For how long after the risky sexual encounter may levonorgestrel be used?
Up to 72 hours, may be used for up to seven days after but is less effective
Dose is doubled if patient is in enzyme inducers
What are the side effects of oral EC?
In practice very few have side effects
Nausea and vomiting
Breast tenderness
Disturbance of menstruation
Dizziness, tiredness, headache
What does the symptothermal method of contraception rely on?
Temperature, which rises after ovulation
Mucus, presence, absence and characteristics
Cervix, position and degree of opening
What is the failure rate of the symptothermal method?
25%
What criteria must be fulfilled for the lactational amenorrhea method? And what is the failure rate?
Must be completely amenorthoeic
Fully breast feeding - through the night
Up to six months in western countries
What is the failure rate of female sterilisation?
One in 200 lifetime risk
Increased rate of ectopics
May be reversible, but depends on the method used
What is the failure rate of vasectomy?
Lifetime failure rate one in 2000
Reversal is usually possible
