Flashcards in Contraceptives Deck (24)
Which age group are COCs contra-indicated in?
women over 50
The oestrogen in COCs increases the risk of what?
- VTE (smoking, obese, >35, immobile)
- Arterial TE (DM, HTN, migraine)
avoid if 3 or more are present
When travelling what should you do when on COCs?
- Stop for journeys longer than 3 hours
- Get compression stockings
How soon before surgery should oestrogen containing contraceptives be discontinued?
- 4 weeks
What would you do if a patient is not able to discontinue an oestrogen-containing contraceptive during major surgery?
- thromboprophylaxis with heparin
- this only counts with major surgery, not needed for minor
What are reasons to stop COCs or HRT immediately?
- sudden chest pain/breathlessness
- unexplained swelling/severe pain in calf of one leg
- severe stomach pain
- high BP
What is medroxyprogesterone acetate?
- long acting progesterone given by injection
- usually lasts 2 years
Which risk factors should you consider a different type of contraception instead of medroxyprogesterone?
- women with osteoporosis
What is norethisterone enantate (noristerat)?
- long acting progesterone given as oily injection that provides contraception for 8 weeks
How long does the nexplanon implant provide contraception for?
- 3 years
What are examples of progesterone only intra-uterine systems?
What is Mirena licensed for?
- primary menorrhagia
- prevention of endometrial hyperplasia during oestrogen replacement therapy
Are progesterone only contraceptives ok to use before surgery?
- Can be used instead of COCs
When would spermicidal contraceptives not be suitable?
- People who have or at high risk of STIs
When can emergency contraception be offered after child birth?
- 21 days after
When can emergency contraception be offered after abortion/miscarriage/ectopic pregnancy?
- 5 days after
How soon after unprotected sex can the IUD be inserted to prevent pregnancy?
- 120 hours after (5 days)
(or up to 5 days after earliest likely ovulation)
What are examples of emergency hormonal contraception?
When is levonorgestrel most effective?
- When taken within 3 days (72 hours)
When is ulpristal most effective?
- When taken within 5 days (120 hours)
If bMI was greater than 26 or body weight was greater than 70kg, which emergency hormonal contraceptive would you give?
What would you do if someone was using short term enzyme inducing drug treatment (2 months or less)?
- Continue on the hormonal contraception but take extra precautions like use condoms
What would you do if someone was using long term enzyme inducing drug treatment (more than 2 months)?
- use monophasic COC at a dose of ethinylestradiol (50mcg or more daily)