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REPRO > NON-LARC > Flashcards

NON-LARC Flashcards

1
Q

What affects choice of contraception?

A

control

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2
Q

What are combined hormonal contraceptions?

A

Mix of estrogen and progesterone

  • pill
  • patch
  • vaginal ring
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3
Q

Failure rate of CHC?

A
  • 0.3% if perfectly used

- 9% with typical use

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4
Q

How to take COC?

A
  • start in first 5 day of the cycle
  • or any time when SURELY not pregnant plus condom for 7 days
  • take daily for 21 days+ 7 day break
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5
Q

What is meant by break-through bleed?

A
  • slight spotting that occurs with use of COC (NOT period)

- if bleeding goes on for more than 4 days; stop COC for 4 more days and then continue

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6
Q

What affects the effectiveness of COC?

A
  • impaired ABSORPTION (GI conditions)
  • increased metabolism (liver enzyme induction or drug interaction)
  • forgetting
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7
Q

How may risk of VTE vary with COC drugs?

A
  • varies according to EE dose and progestogen types

- —-3rd gen of Progestogens has a HIGHER risk of VTE

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8
Q

WHat is the VTE risk in pregnant women?

A

21-30 per 10 000

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9
Q

Post-natal VTE risk ?

A

130-140 in 10 000

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10
Q

When is migraine dangerous with the pill?

A
  • when you have an AURA (5-20 mins prior to headache)
  • –USUALLY IN THE FORM of a SCOTOMA
  • OR hemiparesis/smell/taste/altered sensation
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11
Q

What is the danger of having the pill if you have migraines with aura?

A
  • ischemic stroke

- so CHC is C/I in people with migraine with aura

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12
Q

Another risk of using the pill?

A
  • age > 35 YEARS
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13
Q

What is an unwanted effect of pill?

A
  • increased risk of breast cancer (1.24 risk)
  • cervical cancer ( use of >5 years)
  • —-do regular smear and condom use
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14
Q

What examination is done prior to first CHC prescription?

A
  • record BP and BMI before 1st prescrip.
  • smear status
  • multiple risk factors?
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15
Q

Best acne protection by______.

Why?

A

Dianette (Cyproterone Acetate = anti-androgen, progestagen)

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16
Q

WHat are the non-contraceptive benefits of CHC?

A
  • PCOS (fewer functional ovarian cysts)
  • menorrhagia
  • —-though regular withdrawal bleeding
  • reduced PMS
  • acne rx
  • protec. against ovarian cancer (50% reduct. after 15 years of use) and endometrial cancer
17
Q

Best avoid COC in _______

A

bleeding disorders.

18
Q

What is as effective as COC?

A
  • Cerelle
    (progesterone only pill )
    —–ensure you take it every single day
19
Q

What is a s/e of the progesterone-only pill?

A
  • irregular bleeding
20
Q

What is DEPOT PROVERA?

A
  • depot injection every 3 months…LOWERS estradiol, supresses FSH
  • causes AMENNORHOEA (esp. nice if people want this)
21
Q

What is Sayana Press?

A
  • self-administration

- LOWERS estradiol, supresses FSH

22
Q

Advantage and disadvantage of hormonal Depots?

A
  • not affected by enzyme inducing drugs

- (-VE): osteopenia

23
Q

The most effective contraception ?

A
  • Sub-dermal implants
24
Q

When is a diaphragm indicated?

A
  • mid-30s
  • no regular partner
  • on cancer treatment
25
Q

What should be remembered for diaphragm?

A
  • leave it for 6 HRS after sex

- more spermicide needed after 3 hrs if you have more sex

26
Q

What techniques are involved in a vasectomy?

A
  • local/general anaesthetic

- NO scalpel needed

27
Q

What are complications of the vasectomy?

A
  • pain
  • infection
  • bleeding
  • anaesthetic
28
Q

How is female sterlization done?

A
  • clips over the fallopian tubes; bands; essure

- done LAPROSCOPICALLY

29
Q

What does natural planning involve?

A
  • app where you insert personal information about various things to obtain fertile window
30
Q

Risks of CHC?

A
  1. Venous Thrombosis
  2. Arterial thrombosis
  3. Adverse effects on some cancers !
31
Q

Is there a particular s.e with the use of COC on blood pressure?

A
  • systemic hypertension!
  • —COC use shows a SMALL increase in BP in some (so check initially at 3 months, then annually)
  • –>140/90
32
Q

What are some arterial pathologies that may arise from CHC use?

A
  • small INCREASED risk of MI in COC users (esp. smokers)
  • increased risk of ISCHEMIC stroke in COC users
  • —-Hypertensive COC users are at a higher risk of MI and stroke then hypertensive non-COC users
33
Q

How “protective” is CHC against ovarian cancers?

A
  • 5 years of use: 20% reduction in ovarian cancer

- 15 years of use: 50% reduction

34
Q

How protective is CHC against endometrial cancer?

A
  • 20-50% reduction
35
Q

What are side effects of COC?

A
  • nausea
  • spots
  • bleeding
  • breast tenderness
36
Q

How to start PO- methods (pill, patch or DMPA)?

A
  • day 1-5 of period
    OR
  • anytime if certain youre not preggers + 7 days of condoms (2 for POP)

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