Contraception Flashcards

1
Q

How many sexually active people who aren’t planning pregnancy don’t use contraception?

A

12%

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2
Q

Which contraceptives are irreversible?

A

Sterilisation

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3
Q

Which contraception is most effective?

A

vasectomy followed by implant

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4
Q

Which contraceptions are there for males?

A

Vasectomy or condoms

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5
Q

What is the pearl index?

A

The number of contraceptive failures per 100 women-years of exposure.

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6
Q

What is L.A.R.C

A

Long-acting reversible contraception:
IUD
Implant
Injections

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7
Q

what is method failure?

A

Pregnancy despite correct use of method

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8
Q

What is user failure?

A

pregnancy because the contraceptive method isn’t used correctly

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9
Q

How many women will become pregnant when using NO contraception?

A

80 women per 100.

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10
Q

Which days are ovulation most likely to occur?

A

Day 12-18 of cycle

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11
Q

How long does the egg survive?

A

24hrs

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12
Q

How long does sperm survive?

A

most <4 days

some >7 days

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13
Q

Which days have the highest chance of pregnancy?

A

days 8-19 of menstrual cycle

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14
Q

What are the options for combined hormonal contraception?

A

BOTH progesterone and oestrogen:

  • pill (1 week break)
  • patch (changed weekly)
  • ring (21/24hrs daily)
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15
Q

What are the benefits of combined hormonal contraception?

A
  • regulate/reduce periods
  • stop ovulation
  • reduce ovarian cysts
  • 50% reduction in ovarian and endometrial cancer
  • improves acne/hirsutism (decreased androgen)
  • reduced benign breast disease
  • reduced rheumatoid arthritis
  • reduced colon cancer
  • recused osteoporosis
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16
Q

What are the MINIMAL side effects of combined hormonal contraception?

A
  • breast tenderness
  • nausea
  • headache
  • irregular breakthrough bleeding (1st 3 months)
  • mood
  • weight (unknown)
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17
Q

What are the SERIOUS side effects of combined hormonal contraception?

A
  • Increased risk of venous thrombosis (DVT, PE)
  • increased risk of arterial thrombosis (MI, stroke)
  • increased risk of cerical cancer
  • increased risk of breast cancer (only for 10 years)
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18
Q

What are contraindications of the combined hormonal contraception?

A
  • BMI >34
  • reduced mobility
  • Family history of VTE
  • smokers >35
  • history of arterial thrombosis or focal migraine
  • > 50yrs
  • Hypertension >140/90
  • previous breast cancer
19
Q

What are the options for the progesterone only hormonal contraception?

A
  • pill (desogestrel 12 hr window or traditional 3hr window)
  • IUD
  • jab (every 13 weeks)
  • rod
20
Q

What are the contraindications of the progesterone only contraception?

A
  • GI upset
  • personal history of breast cancer
  • benign/malignant past/present liver tumours
21
Q

What are the side effects of the progesterone only contraception?

A
  • increased appetite
  • hair loss/gain
  • mood change
  • bloating/fluid retention
  • headache
  • acne - worsen or improve
22
Q

What are the benefits of the progesterone only contraception?

A
  • no increased risk of venous or arterial thrombosis

- very little contraindications

23
Q

What are the side effects of the progesterone only PILL?

A
  • increased appetite
  • hair loss/gain
  • mood change
  • bloating/fluid retention
  • headache
  • acne - worsen or improve
24
Q

What are the benefits of the progesterone only PILL?

A
  • no increased risk of venous or arterial thrombosis
  • very little contraindications
  • most users bleed free after 4 months
25
Q

What are the problems involved with the INJECTABLE progesterone?

A
  • fertility delay - average delay of 9 months
  • weight gain
  • affects bone density
  • 1st 2 doses give problematic bleeding
26
Q

What are the benefits of the progesterone ROD?

A
  • inhibits ovulation
  • can last 3 years
  • no weight change
  • 60% beed free
27
Q

What are the disadvantages of the progesterone ROD?

A
  • 30% prolonged bleeding

- more mood changes than other progesterone only methods

28
Q

What are the types of IUD?

A
  • Progesterone only

- Copper coil

29
Q

What are the benefits of IUD (progesterone and copper)?

A
  • no input from user
  • can be fitted at any age
  • effects and side effects immediately leave when taken out
30
Q

What are the disadvantages of the IUD (progesterone and copper)?

A
  • infection risk
  • perforation risk
  • expulsion risk
  • conceiving might be ectopic (but still less than condom)
  • not suitable for pelvic infection, sub mucous fibroids
31
Q

What are the advantages of the copper IUD?

A
  • hormone free
  • last 5-10 yrs
  • no contraindication to MRI
  • toxic to sperm (also prevent implantation of fertilised egg)
32
Q

What are the advantages of the progesterone IUD?

A
  • most women still ovulate but affects cervical mucus and endometrium
  • low circulating progesterone
  • reduces menstrual bleeding after initial 4 months irregular bleeding
33
Q

What are the types of progesterone IUD?

A
  • Mirena: can treat heavy menstrual bleeding and can act as progesterone part of HRT for 5 yrs
  • Kyleena: contraception only, smaller frame and insertion tube
34
Q

What are the types of emergency contraception?

A
  • Copper IUD
  • Levonorgestrel pill
  • Ulipristal pill
35
Q

When should you start contraception?

A

in the first 5 days of your cycle - immediate cover

If after - use condoms/ abstain for next 7 days

36
Q

When can you get pregnant after birth?

A
  • 21 days after delivery

- 5 days after miscarriage or abortion

37
Q

When is breastfeeding classed as contraception?

A
  • first 6 months
  • when feeding every 4 hrs
  • when amenorrhoeic

*Breast feeding women can use any contraception, must wait 6 weeks after childbirth before using combined oral contraception)

38
Q

Which drugs do the pill, patch, ring and implant interact with?

A

Enzyme inducing drugs - rifampicin, topiramate, carbamazepine

39
Q

What is female sterilisation?

A

filthiest clips are applied across the Fallopian tube to block the lumen

  • failure rate of 1 in 200
  • reduces ovarian cancer risk
  • no effect on periods or hormones
40
Q

What is male sterilisation?

A

Vasectomy - the vas deferent is divided and the ends cauterised.

  • takes 4-5 months to be effective
  • failure rate of 1 in 2000
  • <1:100 long term testicular pain
41
Q

What is the procedure for the termination of pregnancy?

A
  • Surgical (5-12 weeks)

- Oral - mifepristone and misoprostol

42
Q

When can abortion be done at home?

A
  • when under 10 weeks gestation
43
Q

What should you consider when giving ellaone for emergency contraception?

A

It contains uripristal acetate.
DONT use hormonal contraception for the following 5 days.
If having sex, use a barrier method.

Levonelle - theres no interaction with this medication so you can begin hormonal contraception immediately.