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YEAR 3 GP - RT > Tutorial 12 - Contraception and sexual health > Flashcards

Tutorial 12 - Contraception and sexual health Flashcards

1
Q
  1. What is the contraceptive implant and how does it work?
  2. When is it indicated/contraindicated?
  3. Important side effects?
  4. What are the advantages
  5. What are the disadvantages?
A
  1. Small, flexible rod placed under skin. Releases progestogen in pulsatile manor. Stops ovulation. Makes cervical mucus more thick and acidic.
  2. Indicated in women who cannot use contraception with oestrogen in it. Contraindicated if pregnant or if on medication that reduces efficacy of implant i.e., medication for HIV, epilepsy and TB.
  3. Some bruising/swelling on site of implant. Acne. Headaches, nausea , breast tenderness and mood swings for the first few months.
  4. Advantages: Works long term (3 years), fertility comes back quickly, don’t ned to remember to take a pill.
  5. Disadvantages: Requires a procedure to fit/remove patch.
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2
Q
  1. How do intrauterine devices (IUD) work?
  2. When is it indicated/contraindicated?
  3. Important side effects?
  4. What are the advantages
  5. What are the disadvantages?
A
  1. Small plastic/copper device is implanted in uterus. The device stops implantation and kills sperm.
  2. Indicated in women who cannot use oestrogen based contraception. Contraindicated in pregnancy (infection risk), people with abnormal womb/cervix.
  3. Heavier/ longer/more painful periods in first few months. Small risk of infection(PID).
  4. Advantages: Works long term (5-10 years), fertility comes back quickly, don’t ned to remember to take a pill.
  5. Disadvantages: Side effects (regarding periods, infection risk), need to visit GP to have fitted/removed.
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3
Q
  1. How do intrauterine devices (IUS) work?
  2. When is it indicated/contraindicated?
  3. Important side effects?
  4. What are the advantages
  5. What are the disadvantages?
A
  1. Small, plastic T shaped device implanted in uterus. Releases progestogen - this increases acidity and thickness of cervical mucus.
  2. Indicated in women who cannot use oestrogen based products. Contraindicated if problem with womb/cervix or suspected STI/PID.
  3. Headache, acne, breast tenderness.
  4. Advantages: Can make periods lighter, shorter less painful. Can work for 3-5 years.
  5. Disadvantages: Needs to be fitted by GP. Headache, acne, breast tenderness, mood swings can be experienced.
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4
Q
  1. How do contraceptive injections work?
  2. When is it indicated/contraindicated?
  3. Important side effects?
  4. What are the advantages
  5. What are the disadvantages?
A
  1. Progestogen based injections given 3 monthly. Stop ovulation.
  2. Indicated in most women. Not indicated in women who want to have a kid in the next year(can take 3-6 months for fertility to come back). Osteoporosis (reduces oestrogen levels - can thin bones, not recommended to be in for more than 2 years).
  3. Weight gain, headache, mood swings, breast tenderness.
  4. Advantages: Don’t need to worry for 8-13 weeks, does not interrupt with sex, don’t need to remember to take pill.
  5. Disadvantages: Does not protect from STI’s, side effects may last for 8-13 weeks, fertility and periods not normal until a year.
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5
Q
  1. How does the contraceptive patch work?
  2. When is it indicated/contraindicated?
  3. Important side effects?
  4. What are the advantages
  5. What are the disadvantages?
A
  1. Small patch is stuck on skin, it releases oestrogen and progesterone - which stop ovulation. It is replaced weekly for 3 weeks, then you take a break for 1 week.
  2. Indicated in most cases, but contraindicated if over 35, obese, smoker.
  3. Blood clots, potential increase in breast/cervical cancer.
  4. Advantages: Easy to use, only need to think about it once a week, does not interrupt sex, does not matter if your vomit/diarrhoea (as not absorbed by stomach).
  5. Disadvantages: Visible, skin irritation, no protection against STI, weekly change needed, headache/nausea/breat tenderness/mood swings.
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6
Q
  1. How does the contraceptive vaginal ring work?
  2. When is it indicated/contraindicated?
  3. Important side effects?
  4. What are the advantages
  5. What are the disadvantages?
A
  1. Small plastic ring, inserted into vagina monthly - releases progesterone and oestrogen - stops ovulation.
  2. Contraindicated in women over 35, obese, smokers - due to risk of clots.
  3. Breast/cervical cancer risk. Blood clot risk.
  4. Advantages: Does not interrupt sex, don’t need to think about it every time you have sex, not affected by vomiting/diarrhoea, period vomit becomes lighter/less painful.
  5. Disadvantages: May not be comfortable inserting/removing, temporary side effects i.e., mood swings, headache, nausea. Need to remember to change it. Some medicines can make it less effective. Does not protect against STI.
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7
Q
  1. How does the combined (COCP) pill work?
  2. When is it indicated/contraindicated?
  3. Important side effects?
  4. What are the advantages
  5. What are the disadvantages?
  6. What should be done in event of missed pill?
  7. What should I do if I am sick/diarrhoea?
A
  1. Contains artificial oestrogen and progesterone. Stops ovulation. Each pack contains 21 active pills, and 7 “sugar pills”.
  2. Contraindicated in those who are pregnant, smoke, over the age of 35, obese, on certain medication (epilepsy - phenytoin, HIV - antiretrovirals).
  3. Headache, nausea, mood swings, low risk of blood clots and breast/cervical cancer. But reduces risk of endometrial and ovarian cancer.
  4. Advantages: Reduces risk if certain cancers. Helps acne. Can make periods less heavy/painful. Does not interrupt sex.
  5. Disadvantages: Temporary side effects i.e., headache, nausea, mood swings, breast tenderness. Can increase risk of breast cancer and blood clots. Does not protect against STI.
  6. If missed one pill, take as soon as remember - still protected. If missed 2 or more take the last one you missed (even if this means taking 2 in1 day) and use barrier contraception for 7 days.
  7. If only one bout, retake and you will be fine. If continuous take the excreted dose but also use contraception.
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8
Q
  1. How does progestogen only pill work?
  2. When is it indicated/contraindicated?
  3. Important side effects?
  4. What are the advantages
  5. What are the disadvantages?
  6. What should be done in event of missed pill?
  7. What should I do if I am sick/diarrhoea?
A
  1. Progesterone helps thicken and acidify cervical mucus.
  2. On medication that affects efficacy of POP. History of breast cancer.
  3. Ovarian cysts, nausea, headache, breast tenderness, mood swings.
  4. Advantages: Does not interrupt sex. Good option if oestrogen contraindicated.
  5. Disadvantages: Does not protect against STI. Need to remember to take at same time of day. Some common medicines can effect efficacy.
  6. If more than 3 hours late, take the dose but you are not protected - so use barrier for 48 hours.
  7. If only one bout, retake and you will be fine. If continuous take the excreted dose but also use contraception.
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9
Q
  1. How do condoms work?
  2. When is it indicated/contraindicated?
  3. Important side effects?
  4. What are the advantages
  5. What are the disadvantages?
A
  1. Barrier mechanism.
  2. Most people can use condoms. If you have allergy/irritation you may not want to use it, people who struggle to maintain an erection may not want to use it as you need got keep an erection to stop sperm entering vagina.
  3. Irritation.
  4. Advantages: Protects against STI, very reliable, no prep needed.
  5. Disadvantages: Allergy and irritation, can rarely split, may interrupt feeling of sex.
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10
Q
  1. What is tubal ligation and vasectomy?
  2. What are its advantages?
  3. What are its disadvantages?
A
  1. Tubal ligation is a females “sterilisation” - it is when the Fallopian tubes are cut/blocked to stop eggs reaching sperm. Vasectomy is the male version where the vas deferens is cut and sealed.
  2. Advantages: Effective, does not effect sex, does not effect hormones.
  3. Disadvantages: Does not protect against STI’s, cannot easily be reversed, can fail.
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11
Q

What are the options for emergency contraception?

A
  • Morning after pill - Levonelle. High dose progesterone to stop ovulation. Must be taken within 72 hours of unprotected sex.
  • IUD - Contains copper. Toxic to sperm.
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12
Q

What contraception would you advice to women who have heavy/painful periods?

A
  • COCP pill
  • POP pill
  • IUS
  • Patch
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13
Q

Which contraception would you avoid in family who plan to have a baby in near future?

A
  • Contraceptive injection
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YEAR 3 GP - RT (24 decks)

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