OGCO-E7 Guidance after incorrect use of combined oral contraception Flashcards
What is guidance for late restarting after hormone free interval?
What is guidance for 1 missed pill (48 -<72 hours since last pill in current pack was taken?
What is guidance for 2 or more missed pill (>72 hours since last pill in current pack was taken?
What is the history taking for initiating combined oral contraceptives?
PE before prescribing COCs?
What are contraindications to use of COCs?
What is the counselling of COCs?
1) How to take pills
2) Efficacy of COC
3) Non-contraceptive benefits
4) Minor side effects
5) Major complications and related symptoms
6) Missed pills management
How to start taking CCOs?
> 21 days postpartum if not breastfeeding, >6 months if breastfeeding
- If start within 5 days after the start of menses, no additional contraceptive needed
- Can start any time if it is reasonably certain that she is not pregnant. If it is more than 5 days since LMP, add additional contraceptive for the next 7 days.
How to switch from other contraceptives to COC?
- From other hormonal contraceptives: start COC immediately if she has used the hormone perfectly or it is reasonably sure that she is not pregnant. No need to wait for her next menses.
- From hormonal injectable: start COC when the repeat injection is due.
- From IUCD / IUS: start within 5 days of next menses and the IUCD / IUS can be removed after pill started. If COC is started after Day 5 of menses or she has coitus in this cycle, remove IUCD during her next menses.
How to manage missed pills for COCs?
How to minimize risk of pregnancy if missed pills in the 1st week, 2nd week or 3rd week?
What is the FU for COC usage?
1) Acceptability, side effects, compliance and correct usage
2) Review personal and family medical history to identify new contraindications
3) Routine weighing and bimanual examination are unnecessary
4) Blood pressure
5) Practice of other screening tests should not be affected and should be reminded
What COC drugs are available in public hospital?
Microgynon and Diane-35
Diane-35 associated with 4x increase in venous thromboembolism compared with 2nd gen COC and therefore not indicated solely as a contraceptive. It is a treatment for hyerandrogenic symptoms –> should be ideally withdrawn 3-4 months after the treated condition has resolved.
What POP contraceptive is available in public hospital?
desogestrel 75mcg (used when patient has medical contraindication to estrogen or have intolerable estrogen related side effects, or lactating women)
What are the recommended regimens for emergency contraception?
