Flashcards in Contraception Deck (55):
What is the primary mode of action of the COCP?
Inhibits ovulation (does this by reducing production of FSH and LH)
What is a secondary mode of action of the COCP?
Thickening of cervical mucus
What should a patients blood pressure be below to start the COCP?
You have just started a 29 year old women on the COCP for the first time. When do you need to check her blood pressure?
At three months
Anually after that
What COCP is useful if a patients has acne and/or hirsutism?
Co cyprindiol (Dianette)
Is the risk of cervical cancer increased or decreased with COCP use?
What two measurments are important to record before the first prescription of the COCP?
What two cancers is use of the COCP protective from?
When can the COCP be started that means no other means of contraception needed from day 1?
Up to day 5 of the cycle
If the COCP is started on day 10 of the cycle, how many days will it be until the women has contraceptive cover?
How long after taking levonelle 1500 should you use a barrier contraception/abstain for?
How long after taking ellaOne how long should you wait before starting contraception?
What should you do if you miss one COCP?
Take the missed pill as soon as remembered and take the remaining pills at the normal time. Emergency contraception not required
What should you do if you miss 2 COCP pills?
Take the most recent missed pill
Take the remaining pills at the correct time
Use condoms/abstain until 7 pills have been taken consecutively
If you miss more that 2 pills in the last week of a pack what should you do to minimise risk of pregnancy?
Omit the next pill free interval
Which week is pregnancy most likely if you have missed two pills and you have had sex?
1st week of a pack
How long can a contraceptive patch stay off for before its efficacy is reduced?
How many days can a patch be worn for before its efficacy is reduced?
9 days (7 days + 48hrs)
Describe how you use a contraceptive patch
1 patch is applied and worn for 1 week to suppress ovulation. Thereafter the patch is reapplied weekly for a further 2 weeks. The fourth week is patch free to allow a withdrawal bleed.
Describe how you use a vaginal ring?
Ring placed in the vagina and left for 21 days. After this there is a ring free interval for 7 days when there will be withdrawal bleed and then a new ring should be inserted
How long can a vaginal ring be out of the vagina for before its efficacy is reduced?
How long can a vaginal ring be worn for before its efficacy is reduced?
Which progesterone out of these 3 is the longest acting:
What the primary mechanism of the progesterone only pill?
Thickening cervical mucus
What is the primary mechanism of the etonorgestrel progesterone pill?
Thickening of cervical mucus and suppression of ovulatuon in 97% of cycles
What are the secondary mechanisms of the progesterone only pills?
Suppression of ovulation
Reduced endometrial receptivity to blastocyst
Reduction in cilia activity in fallopian tube
Which progesterone out of these 3 is used in newer progesterone only pills:
Etonorgestrel. Due to it being longer acting
Describe how you take the progesterone only pill?
Daily at the same time with no break
With the older progesterone pills (levonorgestrel & norethisterone) how may hours have should there be between doses?
Between 24 - 27 hours
With the newer progesterone pills (etonorgestrel) how many hours should there be between doses?
24 - 36. Longer window than older POPs
How many progesterone only pills do you have to miss to require emergency contraception?
List 5 methods of natural family planning
1. Basal body temperature
2. Cervical mucous thickness
3. Cervical position
4. Calculating fertile days
What is the position of the cervix when you are fertile?
High in the vagina, soft and open
What is the position of the cervix when you are less fertile?
Low in vagina; firm and closed
In a 28 day cycle what days are you most fertile?
Days 8 - 18
What are the three criteria that you need to fulfil to make breastfeeding a reliable contraceptive?
1. Only breast feeding
2. Less that 6 months post natal
What does it mean if a contraception is in category MEC 1?
No restriction for use of this contraceptive method
What does it mean if a contraception is in category MEC 2?
Advantages of using this method generally outweigh the risks
What does it mean if a contraception is in category MEC 3?
Risks of using this contraceptive generally outweigh the advantages (expert clinical judgement required)
What does it mean if a contraception is in category MEC 4?
A condition which represents unacceptable risk if the contraceptive method is used.
What calculation is used to work out the pearl index for contraception reliability?
Number of accidental pregnancies x 1200/ Total months of exposure
What is the primary action of the depo provera injection?
What condition do you need to consider the risk off before prescribing depo provera?
When can the depo provera injection be given so it will be effective straight away?
Up to an including day 5 of the cycle
How long do you have to use another method of contraception for if you start the depo provera on day 9?
What are the main side effects of the depoprovera injection?
Delay in return of fertility
Risk of osteoporosis
What is the main mode of action of the IUD?
Inflammatory response in endometrium
What is the main mode of action of the IUS?
Effect on implantation - endometrium rendered unfavourable for implantation
How many days after UPSI can the IUD be fitted for emergency contraception?
How many days after a TOP can the IUD be fitted?
Immediately (of products of conception seen)
How many days after childbirth can the IUD be fitted for emergency contraception?
Either within 48 hrs or after 4 weeks
How many days after childbirth can the IUS be fitted for emergency contraception?
Either within 48 hrs or after 4 weeks
How many days after a TOP can the IUS be fitted?
Immediately (if products of conception seen)
How long is the contraceptive implant licenced for?