Contraception Flashcards by Ella Knight

What are the main types of contraception?

COCP 
POP
Progesterone implant
Progesterone patch 
IUD
IUS
Condoms

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What does the COCP contain?

Oestrogen + progesterone

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How is the COCP taken?

21 days on
7 days off

Take 1 pill a day at a similar time

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What is the effect of the COCP?

Inhibits ovulation
Inhibits follicular development
Thickens cervical mucus

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What are contraindications for the COCP

BMI >35 + >15 cigarettes/day
FHx of VTE <45y
HYpertension 
Immobility 
History of VTE
Migraine with aura

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What are benefits of the COCP?

Improve acne
Reduce menstrual symptoms
Reduce risk of endometrial + ovarian cancer

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Does any additional contraception need to be used when the COCP is started?

If after day 5 - use 7 days of barrier protection

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What are the risks of the COCP?

No STI protection
VTE
Mood changes

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What happens if you miss one COCP?

Take it ASAP - even if 2 in one day

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What happens if you miss 2 or more COCP?

Take 1 ASAP - even if 2 in one day
Use alternative contraception for 7 days

If in last 7 days - do not take break

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What does the POP contain?

Progesterone

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How is the POP taken?

Taken daily - similar time each day

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What is the effect of the POP?

Thickens cervical mucus

Reduces motility of fallopian tubes

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Does any additional contraception need to be used when the POP is started?

If after day 5 - use 2 days of barrier contraception

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What are contraindication for the POP?

Current breast cancer
Liver disease
Ischaemic heart disease

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Who can use the POP?

Older women 
Heavy smokers
VTE history 
HTN 
Breastfeeding women

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What are the side effects of the POP?

Menstrual irregularities 
Increased risk of ectopic pregnancy 
Mood changes
Acne
Weight gain

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What happens if you take the POP <3 hours late?

Continue as normal

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What happens if you take the POP >3 hours late?

Continue and use 2 days barrier contraception

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What does the patch contain?

Oestrogen + progesterone

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How is the patch used?

3 patches - one per week

1 week patch free

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What is the effect of the patch?

Inhibits ovulation

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What is a benefit of the patch?

Can make periods lighter

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What are negatives of the patch?

Skin irritation

Visible

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What happens if you miss a patch in week 1 or 2?

<48 hours - change immediately - continue as normal >48 hours - change immediately - use barrier method for 7 days

What happens if you delay the start of the patch?

Use a barrier method for 7 days

What happens if you delay the removal in week 3?

Remove ASAP | Continue as normal

What does the injection contain?

Progesterone

How is the injection given?

IM injection every 12 weeks

What is the fertility return like with the injection?

Can take up to a year

What is the effect of the injection?

Inhibits ovulation

What are the advantages of the injection?

Reduces risk of ectopic pregnancy Reduces risk of endometrial cancer Safe for breast feeding

What are disadvantages of the injection?

Irregular bleeding Weight gain (3kg/year) Reduces bone density

What does the implant contain?

Progesterone

What is the effect of the implant?

Inhibits ovulation

How is the implant used?

Small procedure to insert If inserted after day 5 - use barrier method for 7 days

What are contraindications for use of the implant?

``` Current breast cancer Liver disease Stroke Ischaemic heart disease Hepatic enzyme inducing drugs ```

How long does the implant last?

3 years

What is the return to fertility like after using the implant?

Returns immediately

What are side effects of the implant?

Irregular/heavy bleeding Nausea Headache Breast pain

What does the IUS contain?

Progesterone

What is the effect of the IUS?

Prevents endometrial proliferation | Thickens cervical mucus

How long does the IUS last?

5 years

Who can use the IUS?

Migraine sufferers Obese patients On hepatic enzyme inducing drugs

What are the uses for the IUS?

Contraception Menorrhagia Prevention of endometrial hyperplasia in oestrogen therapy

What are the contraindications for the IUS?

Pregnancy STI Gynae cancer Anticoagulation problem

What are the side effects of the IUS?

Change in bleeding - usually lighter Mastalgia Mood changes

What does the IUD contain?

Copper

What is the effect of the IUD?

Reduces sperm motility | Prevents implantation

How long does the IUD last?

5-10 years

What are contraindications for the IUD?

Copper allergy Heavy periods Wilson's disease

What are the uses for the IUD?

Older women 2nd line in younger women Emergency contraception

What are side effects of the IUD?

Heavier periods

How long after UPSI can the IUD be used?

120 hours

What is the only contraception that protects against STIs?

Barrier methods - condom - cap

What are permanent contraception options?

Sterilisation

What is female sterilisation called?

Tubal ligation

What is the failure rate for female sterilisation?

1 in 2000

How is female sterilisation done?

Under GA - cut + tie fallopian tubes

What contraception needs to be used alongside female sterilisation?

Other method until 1st period

What is male sterilisation called?

Vasectomy

What is the failure rate for male sterilisation?

1 in 200

How is male sterilisation done?

Under LA - vas deferens cut and tied

How long until a vasectomy works?

Up to 8 weeks Need 2 sperm samples showing azoospermia

What are options for emergency contraception?

Ulipristal acetate Levonorgestrel IUD

What is the brand name for ulipristal acetate?

Ellaone

What is the effect of ulipristal acetate?

Inhibits ovulation

How long after the UPSI can ulipristal acetate be used?

Up to 120 hours

What condition in ulipristal acetate contraindicated in?

Severe asthma

Can ulipristal acetate be used more than once per cycle?

What do you need to do with normal contraception after use of ulipristal acetate?

5 days off of hormonal contraception

What is the effect of levonorgestrel?

Inhibits ovulation

How long after the UPSI can levonorgestrel be used?

Up to 72 hours

Can levonorgesrel be used more than once a cycle?

Yes

When do you double the dose of levonorgestrel?

>70kg | > BMI 35

What do you need to ensure when prescribing to a child?

Gillick competence

What needs to be fulfilled for Gillick competence?

1. able to understand implications of treatment 2. cannot be persuaded to tell parents 3. likely to be sexually active with or without contraception 4. is likely to suffer if no contraception given 5. is in the best interest

What guideline is used when giving contraception?

UKMEC guidelines

Contraception Flashcards

(78 cards)