Contraception Flashcards
(27 cards)
When can a copper coil be inserted for emergency contraception?
Up to 5 days after earliest likely date of ovulation irrespective of date of last UPSI; or up to 5 days after UPSI if this is the only UPSI in the cycle
How many days post-UPSI can ulipristal be used, and how many days after this can regular contraception be started?
5 days
How long after UPSI is levonorgestrel indicated for emergency contraception?
3 days (72 hrs)
How many days additional contraception is required from day 6 of the menstrual cycle, when quick-starting:
a) combined pill
b) progesterone pill
c) progesterone implant/injection
a) 7 days
b) 2 days
c) 7 days
When quick-starting a contraceptive method where it can’t be guaranteed the patient isn’t pregnant, when should a pregnancy test be performed?
21 days
Effect of combined pills on lamotrigine?
Reduced efficacy; therefore poor seizure control
Implications for patients taking enzyme-inducing anti-epileptics?
IUS, IUD, long-acting injectable progesterone are preferred as enzyme inducers reduce the efficacy of oral hormonal contraceptives
When should low-strength oestrogen COCP be used? (4)
Age above 40
Risk factors for circulatory disease
Continuous regimen
Oestrogenic side effects
Alternative dosing regimens for COCP? (3)
Short pill free interval (4 days)
Tricycling (three packs run back to back)
Extended use- continuous monophasic pills until breakthrough bleeding, followed by a pill-free break
Risks of COCP?
Increased risk of venous thromboembolism, ischaemic stroke, breast and cervical cancer
When might emergency contraception be required when taking the combined pill?
If 2 or more pills missed in the first week of a pack, and UPSI in the first week/pill free interval
If two or more COCP have been missed, how long should additional precautions be taken for?
one week
When should patients starting COCP be followed up?
3 months, then every 6 months/annually
Which combined pill is indicated for acne and how long should it be continued after acne symptoms are controlled?
co-cyprindiol; 3 months max
Timeframes for reasonable certainty that patient is not pregnant:
a) last menstrual period
b) non breastfeeding postpartum women
c) post TOP or miscarriage
d) fully breastfeeding
e) negative pregnancy test since last UPSI
a) is currently within first 7 days
b) 4 weeks
c) within 7 days
d) less than 6 months + amenorrhoeic
e) 3 weeks
Benefits of using Cerazette (desogestrel) in preference to other POPs?
Longer missed pill window (12 hrs)
More ovarian suppressive- good for history of ovarian cysts and ectopic pregnancy
When can amenorrhoeic women over 50 stop taking POP?
Two consecutive FSH levels, six weeks apart, above 30. Stop one year after this
How long does Nexplanon last for?
three years
What age can the POP be continued until?
55, when loss of fertility can be assumed
When is COCP indicated in women over 40?
Until age 50, as long as non-smoker with no vascular risk factors
What age can injectable progestogens be used until?
50 years of age
When can non-hormonal methods of contraception be stopped at the menopause?
2 years amenorrhoea if below 50, 1 year amenorrhoea if above 50
Time limit on termination of pregnancy?
24 weeks
When should investigations be offered for infertility?
after 1 year, sooner if >35 or known cause of fertility issues
