Flashcards in Contraception Deck (40):
In a standard 28 day cycle, when is a woman most fertile?
Days 8 to 18
3 criteria for using breast feeding as contraception?
-less than 6/12 post natal
no restriction for the use of contraception method
Where the advantages of using the method generally outweigh the theoretical or proven risks
A condition where the theoretical or proven risks generally outweigh the advantages
A condition which represents unacceptable risk if the contraceptive method is used
If you prescribe contraception, how often do you need to check it?
Give an example of LARC
Give 3 examples of VLARC
How does depo work?
What checks must you do before giving depo?
-check BMI and BP
-check smear status if relevant
-consider risk factors for osteoporosis
When can depo be started?
Up to and including day 5 of the cycle without the need for additional contraception
What happens if a woman wants to start depo after day 5?
Can start depo after day 5, as long as she is 'reasonably certain' she is not pregnant and uses condoms/abstinence for 7 days
A woman wants to start depo after having a baby, when can she start it?
Up to 21 days after having baby with immediate cover
A woman wants to start depo after a TOP, when can she start it?
Up to day 5 since TOP
Side effects of depo?
-delay in return of fertility
-possible risk of osteoporosis!
What is depo and how long does it work for?
-injection similar to progesterone
-works for 12 weeks
Gold standard IUD
IUD primary mode of action
Inflammatory response in endometrium
How long is an IUD licenced for?
IUS primary mode of action?
Effect on implantation
(also effect on cervical mucous and pre-fertilisation effects)
Contraindications to IUD/IUS
-Current pelvic infection
-Abnormal uterine anatomy
-Sensitivity to any of the constituents
-Gestational trophoblastic disease when BHCG levels are abnormal
-Cervical ca awaiting treatment
What checks must you do before giving IUD/IUS?
PV to check uterine size/position
BP and pulse if condition indicates
Can an IUD be used as emergency contraception?
Can an IUS be used as emergency contraception?
How long is the 52mg LNG-IUS licenced for?
How long is the 13.5mg LNG-IUS licenced for?
How long is the rod licenced for?
How does the rod work?
-also effect on cervical mucous and endometrium
When can an implant be fitted?
Within first 5 days of cycle
You want to switch from depo to implant, is this okay?
Yes, if last depo within 14 weeks
You want to switch from the pill to the implant, is this okay?
Yes, fit after last active pill in packet taken
You want to switch from COC/patch/vaginal ring to the implant, is this okay?
Yes if you fit during weeks 2-3 of COC/patch/vaginal ring
You want to switch from POP to implant is this okay?
Need to use protection for the first 7 days
You want to switch from the LNG-IUS to the implant, is this okay?
Need to use protection for the first seven days
This contraception improves the quality if breast milk postpartum
Why does depo improve quality of breast milk?
Depo has high levels of pregestogens which improve milk production
Recognised treatment of mennorhagia in smokers over the age of 35
Mirena coil (IUS)
-releases minimal doses of levonorgestrel every day
-slims down the endometrium thereby reducing menstrual loss over a time span of 4-9 months
This contraception is contra-indicated in smokers over 35 years of age
(contains synthetic oestrogens and these increase risk of cardiovascular effects)