Flashcards in Contraception and termination of pregnancy Deck (55)
For how long do ovum and sperm survive in the female genital tract?
Ovum survives for up to 24 hours
Sperm survives for up to 5 days
What factors are monitored for natural family planning?
Basal body temperature
Standard/ fertile days
How can basal body temperature be used to monitor fertility?
Taken before rising in the morning
Increase of >0.2 sustained for at least 3 days after at least 6 days of lower temp indicates ovulation
Describe the position of the cervix when fertile vs when infertile
Cervix is high in the vagina, soft and open when fertile
Cervix is low in the vagina, firm and closed when less fertile
What days of the menstrual cycle are the most fertile?
8 to 18
What criteria must be met for breastfeeding to be considered an effective method of contraception?
Exclusively breast feeding
Less than 6 months post natal
What methods of contraception are combined hormonal methods and which contain progesterone only?
COC, patches, vaginal ring
POP, implant, depo injection
What methods of emergency contraception may be available to patients?
Oral medications: UPA or LNG
What is the most effective method of emergency contraception?
When can a copper IUD be installed for emergency contraception and what is the reason for this?
5 days after UPSI or up to 5 days after the earliest expected date of ovulation
This is because pregnancy doesn't implant within the first 5 days - so this is a safe time to insert
What are the differences between UPA and LNG, the two oral methods of emergency contraception?
Can work during the LH surge but not after the peak
Up to 5 days post UPSI
High dose progestogen
Works until just before the LH surge
Up to 3 days post UPSI
In which circumstances should UPA, an oral emergency contraceptive NOT be used?
If hormonal contraception has been used in the last 7 days
If the patient has severe asthma, uncontrolled on oral steroids
How do combined methods of contraception, such as the pill, patch or ring work?
Contain both oestrogen and progestogen which act by negative feedback on the pituitary gland to inhibit ovulation, make cervical mucus thick and sticky and make the endometrium thinner
At what body weight would the combined hormonal patch not be recommended?
This is because there is possible decreased efficacy
Which method of contraception has the lowest failure rates?
The contraceptive implant
Which methods of contraception are considered short-acting and which are considered long-acting?
Combined hormonal contraception
What are some of the risks associated with methods of combined hormonal contraception?
What is the treatment for acne and hirsutism which contains a high does of oestrogen and therefore also acts as a contraceptive?
How should a patient on CHC be reviewed?
Check BP at 3 months then either 6 monthly or annually
What is the cut off limit for BP for patients taking a combined hormonal method of contraception?
Migraine with aura is a contraindication for the use of which contraceptive?
Combined oral contraceptive pill
What are the risks and protective benefits for cancers associated with combined hormonal contraception?
Increased risk of breast cancer and cervical cancer
Protection against ovarian and endometrial cancers
The combined hormonal contraceptive is associated with being of benefit for which conditions?
Ovarian and endometrial cancers
When can the CHC, POP, subdermal implant or DMPA all be started?
Within the first 5 days of regular menstruation or anytime in the cycle but should use condoms for the first 7 days
When can IUS or Cu-IUD be started?
At anytime in the cycle if there has been no IPSI in the past 3 weeks or since the last period
How often is the depo injection given?
Every 13 weeks
What are some of the risks of the depo injection?
Increased risk of poor bone mineral density in people who already have bone problems
Interaction with liver enzyme inducers
What may be some of the contraindications to the use of the depo injection?
Age <18 years or >45 years
How does IUS work?
Effects implantation and mucus