Contraception - Other Methods Flashcards
(27 cards)
How often is the progestogen injection administered
every 13 weeks
What is an ADR of the progestogen injection
Associated with a small loss of bone mineral density
What are the guidelines around progestogen injection with regards to the loss of bone density - 4
- Females under 18 may only use if all other options are exhausted
- all females using should be reviewed every 2 years
- should be stopped in females over 50
- not used in females with risk factors for OA
What advice should be given about return of fertility after stopping the progeston injection
fertility may take up to a year to return - however, those who dont wish to concieve should still use other contraceptive methods
Where is the progestogen implant inserted
- Subdermally
- typically proximal non-dominant arm over the tricep
Mechanism of action of implant - 2
- prevents ovulation
- thickens cervical mucus
How long does the p implant last
3 years
What are the benefits of the P implant -3
- the most effective form of contraception
- doesnt contain oestrogen so can be used if past hx of VTE, migraine, stroke ect
- cam be inserted immediately after a termination
What advice should be given surrounding effectiveness when starting the implant
if inserted on day 1 to 5 of cycle, immediate effects
if not, use an additional contraceptive for 7 days
ADRs of the P implant - 2
Irregular/heavy bleeding
Progestogen effects - headache, nausea, breast pain
DDIs of Implant
Enzyme inducers
Contraindications to implant (UKMEC3 - 4, UKMEC4 - 1)
UKMEC3
- IHD, Stroke
- suspicious vaginal bleeding
- past breast cancer
- liver cirrhosis or cancer
UKMEC4
- current breast cancer
Name the two types of intrauterine devices
IUD - copper coil
IUS - progesterone releasing
Mechanism of action of IUS and IUD
IUD - decreased sperm motility and survival
IUS - prevents endometrial proliferation and thickens cervical mucus
How long do the IUD and IUS last
IUD - most are 5 years, some last up to 10
IUS - 5 years
When does the IUD and IUS become effective
IUD - immediately after insertion
IUS - becomes effective after 7 days
Problems of intrauterine devices - 6
IUDs make periods heavier, longer and more painful
the IUS is associated with initial frequent uterine bleeding and spotting. Later women typically have intermittent light menses with less dysmenorrhoea and some women become amenorrhoeic
uterine perforation
the proportion of pregnancies that are ectopic is increased but the absolute number of ectopic pregnancies is reduced, compared to a woman not using contraception
PID
expulsion is most likely to occur in the first 3 months
What are the male and female steriliation procedures and explain them
Vasectomy - vas deferens is snipped and ties to prevent sperm entering the ejaculate
Tubal Ligation – fallopian tubes are occluded to prevent ovum transport
Name the 2 emergency contraceptives
Levonorgestrel (progesterone)
EllaOne AKA Ulipristal (a SERM)
What is levonorgestrel mechanism of action - 2
- stops ovulation
- inhibits implantation
When must levonorgestrel be taken by
Within 72 hours of unprotected sexual intercourse
Efficacy decreases with time
what advice around weight should be taken into account when prescribing levonorgestrel
If BMI is over 26 or weight over 70kg, then double the dose
Mechanism of action of EllaOne - 1
Inhibits ovulation
When should ellaone be taken by
120 hours after unprotected sex
