Long-acting Contraceptives Flashcards
(45 cards)
What is measured for the natural family planning method of contraception?
Basal body temp Cervical mucus Cervical position Standard (fertile) days Breast feeding
What is cervical mucus like:
post-ovulation
ovulation and 3 days after?
Post-ovulation - thick and sticky
Ovulation and 3 days after - thin, watery, stretchy
What position is the cervix when the woman is:
fertile
less fertile?
Fertile - cervix is high in vagina, soft and open
Less fertile - cervix is low in vagina, firm and closed
On what days of menstrual cycle is the woman most fertile?
Days 8 - 18
What are the 3 criteria for using breast feeding for natural family planning?
Exclusively breast feeding
Less than 6 months post-natal
Amenorrhoeic
What is the pearl index for contraception?
Failure rate
i.e. the number of contraceptive failures per 100 women users per year
How is the pearl index worked out?
Number of estimated accidental pregnancies x 1200/ total number of months of exposure
What are the main types of long acting reversible contraception? and it’s pearl index?
Injectable contraceptive -
Depo provera IM
Sayana press (sub cut)
Pearl index - 0.2%
What is the mode of action of depo provera?
Inhibit ovulation
(also thickens cervical mucus
and makes endometrium thin)
How often is depo provera given?
Every 13 weeks (will last 14)
What are prior examinations that need to be done before giving depo inj?
BP
Smear status
Risk factors for osteoporosis
What are the modifiable risk factors for osteoporosis?
Underweight Prolonged steroid use Excess alcohol intake Immobility Smoking
What are the unmodifiable risk factors for osteoporosis?
Hypothyroidsm Coeliac disease Rheumatoid arthritis Hyperparathyroidism IBD Chronic renal disease
How long does it take to inhibit ovulation?
7 days
On what day of menstrual cycle should depo be started to avoid need for additional contraception?
Day 5
On what day of menstrual cycle are women most fertile?
Day 14 (ovulation) - therefore give depo on day 5 (takes 7 days to inhibit ovulation) = day 12 i.e. before the woman is most fertile/ ovulates
How long can sperm live once past the vagina?
7 days
What are the criteria to say you are ‘reasonably certain’ a woman is not pregnant?
No sex since last period
Consistently using reliable contraception
<7 days since last normal period
<4 weeks post-partum and not breastfeeding
Fully breastfeeding, amenorrhoeic and <6 months post-partum
Negative pregnancy test and >3 weeks since unprotected sexual intercourse (UPSI)
Side effects of depo?
Weight gain due to appetite stimulation
Delay in return of fertility
Irregular bleeding
Risk of oestoporosis
How long can it take for fertility to return after stopping depo injections?
18 months
What are the types of very long acting reversible contraception?
Intrauterine device
Intrauterine system
Implant (progesterone)
How does the intra-uterine device work?
Prevents fertilisation
Copper is toxic to ovum and sperm joining
How can the IUD be used as emergency contraception?
It products an inflammatory response in endometrium which is toxic for the fertilised ovum
How long can the IUD be used for?
5-10 years
