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Genitourinary > Contraception > Flashcards

Contraception Flashcards

(51 cards)

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1
Q

Examples of highly effective contraception

A

IUD, Progesterone implants and injections, combined hormonal ring, and stertilisation

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2
Q

COC cancer risks?

A

Redcued risk of colorectal, ovarian and endometrial cancers

Increased risk of breast and cervical cancers

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3
Q

Which oral contraception has a side effect of improvement in acne?

A

COC

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4
Q

Which oral contraception has a side effect of acne?

A

POP

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5
Q

What increases your risk of VTE, MI or stroke when taking COC?

A

Obesity, smoking, aged over 35, superficial thrombophlebitis, periods of immobility

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6
Q

What age should COC not be used in?

A

Women >50 years old

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7
Q

What increases the risk of arterial thrombomboembolism when taking COC?

A

Migraine with aura, hypertension, diabetes

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8
Q

Can COC cause weight gain and low libido?

A

No evidence to suggest this

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9
Q

CI to COC

A

Smoking over 35 (>15 cigarettes per day)

History of VTE

Migraine with aura or severe migraines

Diabetes mellitus with complications

BMI over 35

Over 50 years

TIA without headache

Severe or multiple risk factors for VTE

<6 weeks postpartum in breastfeeding women

<3 weeks postpartum in non-breastfeeding women with other VTE risks

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10
Q

Action taken if a woman is taking COC with a BP of 160/100mmHg?

A

Stop COC

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11
Q

Action taken if woman presents with signs of liver dysfunction on COC?

A

Stop COC

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12
Q

Which contraceptives can cause a delay in the return of fertility after stopping?

A

Progesterone injectables

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13
Q

Which contraceptives are linked to a loss of bone mineral density?

A

Progesterone injectables
Progesterone implant (not enough evidence)

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14
Q

When should COC be stopped prior to surgery?

A

If major surgery or leg surgery- should be stopped 4 weeks before and re-started 2 weeks after full mobilisation

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15
Q

When is it recommended compression socks and leg exercises should be done when journeying and on COC?

A

For journeys >3 hours

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16
Q

Contraceptive advice for those on enzyme-inducing drugs and COC?

A

Barrier methods recommended during and 28 days after treatment

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17
Q

Which anti-epileptics are particularly worriesome with COC use?

A

Topiramate and lamotrigine

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18
Q

Monitoring requirements for COC?

A

BP and BMI after 3 months, then annually thereafter

Enquire about headaches and migraines

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19
Q

Contraception advice if starting COC after Ulipristal?

A

Wait 5 days before starting COC and use barrier methods for 7 days

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20
Q

Contraceptive advice if starting COC after levonorgestrel?

A

Start immediately but use barrier methods for 7 days

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21
Q

When is EHC generally needed on COC?

Study These Flashcards
A

If 72+ hours since last ACTIVE pill and UPSI occured in HFI or week 1 after HFI

22
Q

When should progesterone only pill be started?

Study These Flashcards
A

On day 1 of cycle- no extra precautions required

23
Q

Contraceptive advice if POP started after day 5 of menstrual cycle?

Study These Flashcards
A

Start POP and use barrier methods for 2 days

24
Q

Contraceptive advice of starting POP 21 days after postpartum?

Study These Flashcards
A

Use barrier methods for 2 days

25
Contraceptive advice if vomiting occurs within 2 hours of taking POP?
Take another pill- no extra precautions required
26
Contraceptive advice if starting POP before day 21 postpartum?
No extra precautions required
27
Contraceptive advice if POP not taken within 3 hours of usual time?
Take missed pill and use barrier methods for 2 days
28
When is EHC recommended for POP?
If 1+ pills missed or not taken within 12 hours of window and UPSI has occured before 2 tablets are taken consistently
29
Difference between cancer risks between COC and POP?
COC decreased risk of colorectal cancer POP has limited evidence on risk of cervical cancers, increased risk of these with COC
30
Side effects of POPs
Headache Acne Weight gain Low mood
31
Link between progesterone injection and cervical cancer risk
Small increased risk of cervical cancer if used >5 years
32
PO IUD side effects
Pain on insertion Uterine perforation- report severe pelvic pain, sudden change in periods, pain during sex, increased bleeding, unable to feel threads Risk of pelvic infection in first 3 weeks IUD rejection, especially in the first 3 months. Link to vulvovaginal candidiasis or BV
33
Which form of contraception is unsuitable for someone with Pelvic inflammatory disease?
IUDs
34
Which contraception causes periods to be longer and heavier?
Copper IUD
35
Minimum time required to keep a cap/diaphragm in folllowing sexual intervourse?
6 hours
36
How long after Levonorgestrel should POP, IMP, or injection be started?
Can be started immediately but barrier methods required for 2 days (7 days drosperidone)
37
How long after EllaOne should POP, IMP, or injection be started?
After 5 days and barrier methods required for 2 days
38
How long after EllaOne should CHC be started?
After 5 days and barrier methods required for 7 days
39
How long after Levonorgestrel should CHC be started?
Can be started immediately but 7 days barrier methods required
40
Effect of desogestrel on lamotrigine concetrations
Increase concs
41
Effect of COC on lamotrigine concetrations
Can decrease lamotrigine concentrations
42
Which parenteral progesterone contraceptive is affected by drug interactions?
Nexplan (progesterone implant)
43
Which contraceptives are not affected by drug interactions?
Cu IUD, hormonal IUD, Progesterone injections
44
Advice on breastfeeding if giving EllaOne?
Do not breastfeed for 1 week after taking EllaOne
45
If patient is taking other contraceptives and given EllaONE what advice should be given?
To use condoms until their next period
46
Advice on breastfeeding if giving EHC- levonorgestrel?
Avoid BF for 8 hours after taking pill
47
Dose of levonorgestrel as EHC if on liver enzyme-inducing drugs?
Double dose of Levonorgestrel to 3mg
48
When is Levonelle used?
Up to 72 hours after UPSI for >16 years old
49
When is EllaONE used?
Up to 5 days after UPSI in any woman of child-bearing potential
50
Cautions and when to refer when a patient is requesting EHC?
If ovulation has already occurred- ellaone is no longer effective Severe hepatic dysfunction Severe diarrhoea Crohn's disease Patients with asthma on oral glucocorticoid therapy Patients on ciclosporin therapy
51
If patient is taking other contraceptives and given Levonorgestrel what advice should be given?
Can continue to take the pill as normal

Genitourinary (8 decks)

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