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Flashcards in Contraception Deck (40):
1

In a standard 28 day cycle, when is a woman most fertile?

Days 8 to 18

2

3 criteria for using breast feeding as contraception?

-Exclusively breastfeeding
-less than 6/12 post natal
-amenorrhoeic

3

UK MEC1

no restriction for the use of contraception method

4

UK MEC2

Where the advantages of using the method generally outweigh the theoretical or proven risks

5

UK MEC3

A condition where the theoretical or proven risks generally outweigh the advantages

6

UK MEC4

A condition which represents unacceptable risk if the contraceptive method is used

7

If you prescribe contraception, how often do you need to check it?

Annually

8

Give an example of LARC

Depo injection

9

Give 3 examples of VLARC

-implant
-IUD
-IUS

10

How does depo work?

Inhibits ovulation

(also effects:
-cervical mucous
-endometrium)

11

What checks must you do before giving depo?

-check BMI and BP
-check smear status if relevant
-consider risk factors for osteoporosis

12

When can depo be started?

Up to and including day 5 of the cycle without the need for additional contraception

13

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

14

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

15

A woman wants to start depo after a TOP, when can she start it?

Up to day 5 since TOP

16

Side effects of depo?

-weight gain
-delay in return of fertility
-irregular bleeding
-possible risk of osteoporosis!

17

What is depo and how long does it work for?

-injection similar to progesterone
-works for 12 weeks

18

Gold standard IUD

380mm^2 copper

19

IUD primary mode of action

Prevents fertilisation
Inflammatory response in endometrium

20

How long is an IUD licenced for?

5-10 years

21

IUS primary mode of action?

Effect on implantation
(also effect on cervical mucous and pre-fertilisation effects)

22

Contraindications to IUD/IUS

-Current pelvic infection
-Abnormal uterine anatomy
-Pregnancy!
-Sensitivity to any of the constituents
-Gestational trophoblastic disease when BHCG levels are abnormal
-Endometrial ca
-Cervical ca awaiting treatment

23

What checks must you do before giving IUD/IUS?

PV to check uterine size/position
BP and pulse if condition indicates

24

Can an IUD be used as emergency contraception?

Yes

25

Can an IUS be used as emergency contraception?

No

26

How long is the 52mg LNG-IUS licenced for?

5 years

27

How long is the 13.5mg LNG-IUS licenced for?

3 years

28

How long is the rod licenced for?

3 years

29

How does the rod work?

Inhibits ovulation
-also effect on cervical mucous and endometrium

30

When can an implant be fitted?

Within first 5 days of cycle

31

You want to switch from depo to implant, is this okay?

Yes, if last depo within 14 weeks

32

You want to switch from the pill to the implant, is this okay?

Yes, fit after last active pill in packet taken

33

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

34

You want to switch from POP to implant is this okay?

Need to use protection for the first 7 days

35

You want to switch from the LNG-IUS to the implant, is this okay?

Need to use protection for the first seven days

36

This contraception improves the quality if breast milk postpartum

Depo

37

Why does depo improve quality of breast milk?

Depo has high levels of pregestogens which improve milk production

38

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

39

This contraception is contra-indicated in smokers over 35 years of age

COC
(contains synthetic oestrogens and these increase risk of cardiovascular effects)

40

Progesterone effect on the GI tract

Delays gastric emptying

Case example from pastest, not really contraception related:

"a 25 year old woman who has been on methadone for the past 3 weeks has a convulsion, why?" Answer: drug and alcohol withdrawal
-since gastric emptying is delayed due to the progesterone effect on the GI tract, insufficient drug levels in the plasma may be the cause for convulsion