GP- Contraception Flashcards
What is microgynon?
A combines hormonal contraceptive
Case:
Claire- aged 23 comes to see you to request a repeat prescrption of her contraceptive pill. SHe is taking microgynon, a combine hormonal contraceptive
What questions would you ask as a student doctor?
Has she found it easy to use/remember?
Has she noticed any adverse effects?
Doe sshe understand how to take it?
Doe she know how to manage missed pills?
Has the pattern of withdrawal bleeds been regular?
Has there been any breakthrough bleedign?
Have there been developments in her medical history (eg new medication) or scial history (eg age and smoking whch need to be considered )
What are the common adverse effects fo microgynon ?
Breakthrough bleeding - MC
Weight gain
other temporary adverse effects may include breast tenderness, headaches and nausea
May cause an inrease in blood pressure
how do you take microgynon?
Take your pill at the same time every day.
Start by taking a pill marked with the correct day of the week.
Follow the direction of the arrows on the strip. Take one pill each day, until you have finished all 21 pills.
Swallow each pill whole, with water if necessary.
What days are pills usually missed?
Day 1 and 2 because women forget after the 7 day interval of not taking it
What are some other ways of taking the pill (off licence but supported by my sexual health faculty)
Tricycling- running three packets back to back. So only haveing that hormone free interval once every three packets
Continuous use- Never having a hormone free interval
Flexible extended use- Pill packets are run continuously until a breakthrough bleed occurs. At the point the breakthrough bleed starts you should stop taking the pill and give herself a hormone free interval for about 3/4 days before starting it again.
Take a packet each month but having the 4 day free interval instead of 7
What happens if you miss one pill?
if you only miss one pill then thats not likely to be a problem. You should just take the pill when you remember.
What happens if you miss two pills in succession?
What is important to check in the medical history of women who is using contraception.
Specifically enquire about:
- Migrane
- smoking
- HTN
- Thrombophilia
- Previous VTE and FHx of VTE
- Hyperlipidaemia
- New medications- anticonvulsants, rifamoicin, St Johns Wort
Record BP and BMI
What is the UKMEC criteria?
UK medical elgibilty criteria
Set of criteria that is written by the faculty of sexual and reproductive health.
They look at every medical diagnosis and they say whether or not for each of those medical diagnoses, each type of contraception is okay or not to use.
WHat is the groups you UKMEC criteria uses
UKMEC 1 - there is no restriction to use. Absolutely fine to use that contraception in that medical condition
UKMEC 2 - There may be some risks but actually the advantages of that method of contraception seem to outweigh the risks of it
UKMEC 3- risks now of that contraceotion are probably outeweighing the advantages of it. So the use is generally not recommended although it can still be used if needs to be
UKMEC 4 - Use of that contraception with that medical condition will result in unacceptable risk to health and should not be used
Migranes while taking contraceptive pill can lead to?
Can lead to ishcameic stoke and so should be stopped
What is the next option if a person cant take contraceptive pill microgynon?
Probably a progesterone only pill (POP)
How do you take POP?
Who should not take POP
Active breast cancer patients
What are coils?
Differences in IUS and IUD coils?
