Fertility / Contraception Bank Flashcards
POP missed pill >3hrs late
Take missed pill asap (only one even if missed several)
Take next pill at usual time (even if taking two pills in a day)
Alternative contraception until normal pill-taking resumed for 48hrs
Exception: desogestrel can be taken up to 12 hours late
IUD mode of action
Prevent fertilisation by:
-Decreased sperm motility and survival
Effective immediately
IUS mode of action
Levonorgestrel:
- Prevents endometrial proliferation
- Cervical mucous thickening
Reliable after 7 days
COCP absolute contraindications
UKMEC 4: represents an unacceptable health risk
- Over 35 and smoking more than 15 cigarettes/day
- Migraine with aura
- History of VTE or thromboembogenic mutation
- History of stroke or ischaemic heart disease
- Breast feeding <6 weeks post-partum
- Uncontrolled hypertension
- Current breast cancer
- Major surgery with prolonged immobilisation (stop 4 weeks before elective, restart once mobilising)
COCP relative contraindications
UKMEC 3: disadvantages generally outweigh the advantages
- Over 35 and smoking less than 15/day
- BMI > 35 kg/m^2
- Family history of VTE in first degree relative <45 years
- Controlled hypertension
- Immobility eg wheelchair use
- Carrier of gene mutations associated with breast cancer eg BRCA1/BRCA2
- Current gallbladder disease
Contraceptive injection mode of action
Depo Provera = medroxyprogesterone acetate 150mg
Inhibits ovulation
Also thickens cervical mucus and thins endometrium
Failure rate of female sterilisation
1 in 200
Emergency contraception - levornogestrel
Levonelle
Stops ovulation and inhibits implantation
Must be taken asap, within 72hours of UPSI
1.5mg or 3mg if BMI >26 or weight > 70kg
Repeat dose if vomiting with 2 hours
Emergency contraception - ulipristal
EllaOne
Progesterone receptor modulator. Inhibits ovulation
30mg dose. No later than 120 hours after UPSI.
Caution in asthma.
Delay breastfeeding for 1 week.
Reduces effect of contraeption - use barried methods for 5 days.
Emergency contraception - IUD
Within 5 days of UPSI
If presents after 5 days, may be fitted up to 5 days after ovulation date
Mode of action COCP
Inhibits ovulation
Mode of action POP
excluding desogestrel
Thickens cervical mucus
Mode of action Desogestrel-only pill
Primary: Inhibits ovulation
Also: thickens cervical mucus
Mode of action injectable contraceptive
medroxyprogesterone acetate
Primary: Inhibits ovulation
Also: thickens cervical mucus
Mode of action implantable contraceptive
etonogestrel
Primary: Inhibits ovulation
Also: thickens cervical mucus
