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MFSRH Part 2 (2023) > Switching or Starting Methods of Contraception > Flashcards

Switching or Starting Methods of Contraception Flashcards

1
Q

Day 4 of natural menstrual cycle and wishes to start implant

A

Can quick start with no additional precautions

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2
Q

Day 1 of natural menstrual cycle and wishes to start estradiol COC (Qlaira)

A

Can quick start with no additional precautions

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3
Q

Day 2 of natural menstrual cycle and wishes to start drospirenone POP

A

Can quick start but will need condoms for 7 days
Consider need for PT and EC

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4
Q

Day 6 of natural menstrual cycle, had UPSI yesterday, wishes to start desogestrel POP

A
  • Consider EC + follow-up PT + usual advice depending on method of EC
  • Can quick start (if no EC, or if LNG EC) and use condoms for 48 hours
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5
Q

Day 7 of natural menstrual cycle, had UPSI yesterday, wants to start LNG-IUD

A
  • Cannot quick-start
  • Offer EC + PT + bridging contraception until 21 days post UPSI with neg PT, and can then have LNG-IUD inserted
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6
Q

Day 29 after term vaginal delivery, still amenorrhoeic, no UPSI since delivery, wishes to start drospirenone POP

A
  • Quick-start and use condoms for 7 days
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7
Q

Currently taking CHC and is on day 9 (perfect use so far), wishes to switch to implant

A

Switch to implant with no additional precautions

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8
Q

Currently taking CHC (perfect use so far), and is on day 1 of hormone-free interval, wishes to switch to LNG-IUD

A

As day 1 of HFI, can switch to LNG-IUD with no additional precautions

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9
Q

Currently taking CHC (perfect use so far), day 2 of hormone-free interval, wishes to switch to DMPA

A

As day 2 of HFI, can switch to DMPA with no additional precautions

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10
Q

Currently taking CHC (perfect use so far), day 2 of hormone-free interval, wishes to switch to LNG-IUD

A
  • Can only switch from CHC to LNG-IUD with no additional precautions on day 1 of hormone free interval
  • Once day 2-7 of HFI, advice depends on UPSI
    – No UPSI since start of HFI: switch and use condoms for 7 days
    – UPSI since start of HFI: insert LNG-IUD, AND restart the CHC for 7 consecutive days
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11
Q

Currently taking CHC (perfect use so far) and is on day 4 of new packet. Wishes to switch to desogestrel POP, had UPSI yesterday

A
  • Continue CHC until has used for 7 consecutive days, and then switch with no additional precautions required
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12
Q

Implant currently in-situ for 9 months, wishes to switch to CHC

A

Switch with no additional precautions

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13
Q

Implant currently in-situ for 3 years 1 month, wishes to switch to DMPA

A
  • PT today, and assuming is negative
  • Switch and use condoms for 7 days
  • Follow-up PT if UPSI in previous 21 days
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14
Q

Implant currently in situ for 4 years 1 month, wishes to switch to LNG-IUD, UPSI 3 days ago

A
  • Cannot fit LNG IUD as risk of pregnancy
  • PT today, offer EC, PT at 21 days post UPSI
  • Can fit LNG IUD once 21 days post last UPSI and neg PT
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15
Q

Last DMPA given 13+6 weeks ago, wishes to switch to implant

A

Insert implant immediately, no additional precautions

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16
Q

Last DMPA given 14+6 weeks ago, no UPSI since 14 weeks, wishes to switch to LNG IUD

A

Fit LNG IUD immediately, use condoms for 7 days

17
Q

Last DMPA given 14+6 weeks ago, UPSI yesterday, wants to switch to desogestrel POP

A
  • PT today, offer EC, PT at 21 days post UPSI
  • Depending on EC, can quick-start POP and use condoms for 48 hours
18
Q

Taking norethisterone POP but wants to switch to desogestrel POP

A

Switch immediately, no additional precautions required

19
Q

Taking levonorgestrel POP but wants to switch to drospirenone POP

A

Switch immediately, but must use condoms for 7 days

20
Q

Taking desogestrel POP, wishes to switch to LNG IUD

A

Switch immediately, no additional precautions required

21
Q

Taking drospirenone POP, wants to switch to implant, is currently on day 14 of active pills

A

Switch immediately with no additional precautions (when on days 8-24 of active pills)

22
Q

Taking drospirenone POP, wants to switch to implant, is currently on day 26 of pills and has not had UPSI in the past 10 days

A
  • Placebo / hormone free interval is days 25-28
  • If no UPSI since start of HFI, can switch to implant immediately but must use condoms for 7 days
23
Q

Taking drospirenone POP, wants to switch to implant, is currently on day 27 of pills and had UPSI yesterday

A
  • Placebo / hormone-free interval is days 25-28
  • Insert implant today
  • Restart DRSP POP until 7 consecutive active pills taken
24
Q

Taking drospirenone POP, wants to switch to implant, is currently on day 2 of pill taking and had UPSI yesterday

A
  • If in days 1-7 of active pills after HFI, and UPSI since start of HFI
  • Can insert implant today
  • Continue DRSP until 7 consecutive pills have been taken
25
Q

Age 30, currently has 52mg LNG IUD in-situ, inserted 5 years 4 months ago, but wishes to switch to desogestrel POP, last UPSI 10 days ago

A
  • Can switch immediately and use condoms for 48 hours (as per 2023 guidance)
    [old guidance would be to remove IUD, commence POP, condoms 48 hours, PT today and PT again 21 days after UPSI]
26
Q

Age 30, currently has 52mg LNG IUD in situ, inserted 5 years 4 months ago, wishes to switch to CHC, last UPSI 4 days ago

A
  • Commence CHC
  • Retain LNG IUD for 7 days after last UPSI
27
Q

Age 30, 52mg LNG IUD in situ, inserted 6 years 4 months ago, wishes to switch to another 52mg LNG IUD, UPSI 10 days ago

A
  • PT neg today
  • Switch devices
  • Follow-up PT 21 days after last UPSI
28
Q

Age 30, 52mg LNG IUD in situ, inserted 7 years 4 months ago, had UPSI 10 days ago, wants another 52mg LNG IUD

A
  • Cannot switch today
  • PT
  • Consider EC + bridging + ?removal
  • Switch devices once 21 days after last UPSI with neg PT
29
Q

Day 1 of natural menstrual cycle and wishes to commence drospirenone POP

A
  • QS immediately
  • No need for additional precautions
30
Q

Currently on day 4 of HFI whilst taking CHC, had UPSI on day 2 of HFI, and wishes to switch to desogestrel POP

A
  • Start CHC until 7 days of active pills/patch/ring
  • Then switch to POP with no additional precautions
31
Q

Currently on day 4 of HFI whilst taking CHC, had UPSI on day 2 of HFI, and wishes to switch to LNG-IUD

A
  • Can insert immediately
  • AND restart the CHC until 7 active pills/patch/ring taken
32
Q

Has the 13.5mg LNG IUD in situ, inserted 3 years 1 month ago, and wishes to switch to 52mg LNG IUD. Had UPSI 9 days ago

A
  • As >3 years and UPSI in previous 21 days, will need to consider retaining LNG IUD and PT 21 days after last UPSI
  • Can then switch if no UPSI in previous 7 days, and will need to use condoms for 7 days

MFSRH Part 2 (2023) (22 decks)

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