L5 Contraception Flashcards
Hormonal Methods of Contraception?
Combined estrogen and progesterone
- Combined oral contraceptive pill (COCP)
- Patch
- Vaginal ring
Progesterone only
- POP
- Implant
- Injection
- Coil
! Never oestrogen only !
MOA of Combined Estrogen/Progesterone Contraception?
Initiating Combined oral contraceptive pill (COCP)
- Start Day 1-5 of menses => Immediate protection
- If starting outside of this time frame, added
protection needed for 7 days
Generations of Combined oral contraceptive pill (COCP)
Further classified as 2nd / 3rd/ 4th generation according to progesterone component:
- 2nd (norethisterone / levonorgestrel): ↑ androgenic side effects but ↓ risk TED e.g. ovranette, microlite
- 3rd (desogestrel/gestodene) less side effects but ↑ risk VTE eg cilest, marviol, mercilon
- 4th (drospirenone, dienogest) best of both but expensive eg yasmin, qlaira
Trial and error with OCP prescribing
Absolute contraindications for COCP?
- ______________postpartum if breastfeeding
- Smoker ≥ _______ , > ________
- BP: systolic ≥ ________ mm Hg or diastolic ≥ ______ mm Hg
- Current or past hx of ______
- __________ disease
- Hx of _______
- Complicated ________________ (pulmonary HPT, atrial fibrillation , subacute bacterial endocarditis
- __________ with focal neurological symptoms
- Current Breast Cancer
- _________ with retinopathy/ nephropathy/ neuropathy
- _______
- Liver tumour ( adenoma or hepatoma)
- < 6 weeks postpartum if breastfeeding
- Smoker ≥ 15 cigs/day , > 35yrs
- BP: systolic ≥ 160 mm Hg or diastolic ≥ 100 mm Hg
- Current or past h x of TED
- Ischemic heart disease
- Hx of CVA
- Complicated valvular heart disease (pulmonary HPT, atrial fibrillation , subacute bacterial endocarditis
- Migraine with focal neurological symptoms
- Current breast cancer
- Diabetes with retinopathy/ nephropathy/ neuropathy
- Cirrhosis
- Liver tumour ( adenoma or hepatoma)
Side Effects of Oral Contraceptives?
Managing Missed Oral Contraceptive Pills?
How to Deal with Breakthorugh bleeding from oral Contraceptive?
Side Effect of Oral Contraceptive?
Benefits of Oral Contraceptive?
Risks of Oral Contraceptives
Cautions for Oral Contraceptives?
Ist Choice Contraceptive?
Monophasic COCP with 20/30 micrograms oestrogen and 2 nd generation progesterone eg. Microlite / Ovranette
Alternative Methods of Combined Estrogen/Progesterone. Advantages/Disadvantages?
Progesterone Only Methods of Contraception?
Advantages/Disadvantages to the progesterone ONly Pill (POP)
Noriday vs. Cerazette?
Levonelle vs. ellaOne?
Any Aditional Advantages/Disadvantages?
Age of consent in Ireland?
