Contraception Flashcards by Megan McLaren

what does the natural family planning method take into account to work as contraception

basal body temperature
cervical mucous
cervical position
‘standard days’
breast feeding

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what does cervical mucous tell you about ovulation

thick + sticky post ovulation

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what does the cervical position tell you about ovulation

when fertile the cervix is high, soft + open

when less fertile the cervix is low, firm + closed

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most fertile days

day 8-18 in a 28 day cycle

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what criteria is needed to know that breast feeding is working as a contraceptive

exclusive breast feeding
less than 6 months post natal
amenorrhoeic

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what is LARC + examples

Long acting reversible contraception

E.g. depo provera IM injection

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what is VLARC + examples

Very long acting reversible contraception

e.g. IUD, IUS, implant

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how does depo provera injection work

inhibits ovulation

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when is the depo provera injection given

every 13 weeks

lasts 14 weeks

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what hormones does the depo injection contain

progesterone only

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side effects of depo injection

irregular bleeding, weight gain, osteoporosis, delay in return of fertility

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what needs to be checked before depo injection is prescribed

BP, BMI, risks for osteoporosis

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risk factors for osteoporosis

underweight / anorexia 
prolonged steroid use
excess alcohol intake
immobility
family history 
smoking

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when can you start depo injection

up to + including day 5 with no additional need for contraception
Any other time providing she is not pregnant + will need to use additional contraception for 7 days

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what is different about the IUD

it is non-hormonal

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how does an IUD work

prevents fertilisation- decreases sperm motility + survival

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side effects of IUD

Longer, heavier, more painful periods

small chance of infection

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when can IUD be inserted

up to 5 days after unprotected sex (immediately effective)

up to 5 days after ovulation

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what hormone does IUS contain

progesterone only

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how does an IUS work

stops implantation

thickens cervical mucous

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side effects of IUS

Irregular bleeding
lighter periods
infection

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when can an IUS be inserted

within first 7 days of cycle- no contraception needed

if after first 7 days, additional contraception is needed for 7 days

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contraindications to IUD/IUS

current pelvic infection
abnormal uterine anatomy
pregnancy
Endometrial/cervical carcinoma

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what should be checked before fitting an IUD/IUS

PV to check uterine size/position

BP and pulse

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what is the implant

a single, non biodegradable subdermal rod

how does the implant work

inhibits ovulation

what hormone does the implant release

progesterone only

how long does the implant last

3 years

when can the implant be fitted

within first 5 days of cycle up to day 5 post 1/2 trimester abortion on of before day 21 post partum

side effects of the implant

irregular bleeding weight gain acne nerve damage/vascular injury on insertion

what does the combined oral contraceptive pill contain

oestrogen + progesterone

how does the combined pill work

inhibits ovulation thickens cervical mucous makes endometrium unfavourable for implantation

side effects of the combined pill

increased risk of venous thromboembolism increased risk of breast + cervical carcinoma increased BP

The combined pill contains 21 pills- how does the system work

first 7 pills inhibit ovulation | remaining 14 maintain anovulation

advice for someone who misses one combined pill

If over 24 hours but less than 48 hours, take the pill ASAP Take remainder of pack as normal no emergency contraception is required

advice for someone who misses two or more combined pills

>48 hours since last pill, take the most recent pill + remainder of pills at the correct time Use condoms/abstain until 7 pills have been taken consecutively

through what mechanism does the combined pill stop ovulation

acts on hypothalamic-pituitary-ovarian axis traduce LH/FSH

what hormones does the patch contain

combined oestrogen + progesterone

how does the patch work

patch worn for 1 week to suppress ovulation patch reapplied weekly for 2 weeks 4th week is patch free to allow withdrawal bleed

main side effect of the patch

withdrawal bleed may be painful

how does the vaginal ring work

ring placed in vagina for 21 days | ring free interval for 7 days to allow withdrawal bleed

side effects of vaginal ring

acne irritability mood changes

contra-indication for combined oral contraceptive

MIGRAINE WITH AURA

what is a migraine with aura

a 'change' occurring 5-20 mins before onset of headahce | may be visual, altered smell, taste, hemiparesis

protective effects of combined oral contraceptive therapy

decreased risk of endometrial and ovarian cancer improves acne lighter periods

what is cyproterone acetate

works as a combined oral contraceptive used in treatment of acne + hirsutism

what types of progesterone only pills are there

new- etonorgestrel | old- levonorgestrel

primary action of progesterone only pills

thicken cervical mucous

action of newer progesterone only pills

inhibit ovulation

what do progesterone only pills interact with

Liver enzymes- inducers of cytochrome P450

How are progesterone only pills taken

same time every day, no break

what happens if someone misses a progesterone only pill + has unprotected sex

emergency contraception + 2 days extra contraception

How many doctors need to sign the HSAI form for an abortion to happen legally

what are the two types of abortion and their time frame in NSH tayside

surgical termination- up to 12 weeks | medical termination- up to 18 weeks + 6 days

grounds for emergency termination

necessary to save the life of the woman | necessary to prevent serious permanent injury to the physical/mental health of the woman

for a medical termination, what are the 3 time frames

early- up to 9 weeks late- 9-12 weeks mid-trimester- 12-24 weeks

what are the stages of a medical termination

1. oral mifepristone 200mg (anti-progesterone) | 2. 24-48 hours later give vaginal prostaglandin e.g misoprostol

what are the methods of surgical termination

vacuum aspiration- 6-12 weeks | dilatation and evacuation- 13-24 weeks (not available in Scotland)

what is required before a surgical termination of pregnancy

cervical priming with vaginal prostaglandin

risks of surgical termination

Pain, haemorrhage, infection, failure procedure, cervical trauma, uterine perforation

methods of emergency contraception

Oral: levonelle, ella one Intrauterine: copper IUD

What time frame can levonelle be given

up to 72 hours post unprotected sex

what time frame can Ella one be given

up to 120 hours post unprotected sex

what time frame can IUD be inserted

up to 120 hours post unprotected sex

Contraception Flashcards

(64 cards)