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GP block (Y3) > Week 7: Contraception and sexual health > Flashcards

Week 7: Contraception and sexual health Flashcards

1
Q

short term contraception

A
  • Combined pill
  • Progesterone only pill
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2
Q

Long term contraception

A
  • IUD
  • IUS
  • Implant
  • Injection
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3
Q

POP MOA

A
  • Only contains progestogen
  • Thickens cervical mucus
  • Stops ovulation
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4
Q

correct use of POP

A
  • >99% effective if taken properly
  • Pill taken every day with no breaks between pills
  • Should be taken at a similar time every day
    • Traditional POP- within 3 hours
    • Desogestrel – 12 hours late
    • No breaks between packs
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5
Q

POP contraceptive protection starts

A

Starting: protection straight away if within 5 days of period, otherwise take for 7 days

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6
Q

benefits of POP

A
  • If you cannot be prescribed oestrogen
  • Periods may stop
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7
Q

POP rules on missed doses, D and V

A
  • If less then 3/12 hours , then take late pill asap
  • If >3/12 hours, then take pill asap, take the next pill at usually times, use extra contraception for next 2 days
  • If sick within 2 hours- take another pill, if over >3/12 hours use condoms for 2 days
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8
Q

COCP MOA

A
  • Pill containing oestrogen and progestogen
  • 3 MOA
    • Stopping ovulation
    • Making cervical mucus thicker
    • Preventing thickening of the endometrium
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9
Q

contraindication of COCP

A
  • >35
  • Smoker
  • Overweight
  • Certain medicines
  • Previous blood clots / family history of blood clots
  • Breast cancer
  • Migraines with aura is an absolute contraindications
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10
Q

correct use of COCP

A
  • Take 1 every day for 21 days and then have a 7 day break (although can decide not to take a break)
  • Take pill at around same time everyday
  • When taken correctly 99% effective at preventing pregnancy
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11
Q

starting the COCP

A
  • If you start the combined pill on the 1st day of your period ( day 1 of menstrual cycle) – protection from pregnancy starts straight away
  • Starting after the 5th day of your cycle- need to take pill for 7 days
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12
Q

side effects of COCP

A
  • Mood swings
  • Nausea
  • Breast tenderness
  • Headaches
  • Small risk of
    • Blood clots
    • Breast and cervical cancer
    • Doesn’t protect against STI
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13
Q

benefits of COCP

A
  • Reduces risk of ovarian, uterine and colon cancer
  • Reduce acne
  • Bleed is lighter and less painful
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14
Q

COCP rules on misses doses, diarrhoea/vomiting

A
  • If you vomit within 3 hours of taking combined pill- take another pill straight and away and the next pill at usual time. If you continue to vomit – use other contraception
  • Very severe diarrhoea – use additional contraception when recovering
  • If more than 24s hour missed, take 2 at a time
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15
Q

types of intrauterine conctraception

A
  • IUD- Copper-bearing intrauterine device (Cu-IUD)
  • IUS - Levonorgestrel- releasing intrauterine system (LNG- IUS)
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16
Q

IUD MOA

A
  • Copper-bearing intrauterine device (Cu-IUD)
  • Releases copper into the womb
  • Alters cervical mucus
  • Spermicide
  • Stops implantation
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17
Q

indication of IUC

A
  • Most people with a womb can use an IUD
  • emergency contraception
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18
Q

contraindication of IUD

A
  • If you think you may be pregnant
  • STI
  • Unexplained bleeding between periods or after sex
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19
Q

correct use of IUD

A
  • 99%% effective
  • Last for 5 to 10 years
  • Insertion
    • Can be inserted during menstrual cycle
    • Cervix position checked
    • STI checks
    • Checking its still in place by feeling for 2 thin threads that hang down from your womb into the top of your vagina
    • Can be taken out at any time and possible to get pregnant
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20
Q

important side effects of IUD

A
  • Periods can be heavier, longer and more painful in first 3-6 months
  • Small risk of infection e.g. PID in first 20 days
  • Small risk of rejection or rupture
  • Does not protect against STI
  • Ectopic pregnancy
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21
Q

benefits of IUD

A
  • For women who can remember to take the pill
  • Works straight away
  • No hormonal side effects
  • Doesn’t effect fertility
  • Doesn’t increase risk of cervical, uterine or ovarian cancer
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22
Q

IUS MOA

A
  • Levonorgestrel- releasing intrauterine system (LNG- IUS)
    • Releases progestogen into the womb
    • Thickens cervical mucus
    • Thins lining of the womb
    • Can prevent ovulation
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23
Q

indication of IUS

A
  • Can be used in those who cannot take COCP
  • Menorrhagia
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24
Q

contraindication of IUS

A
  • Current or past breast cancer
  • Cervical cancer
  • Untreated STI
25
Q

correct use of IUS

A
  • 99% effective, lasts for 3- 5 years
  • If fitted in first 7 days od cycle- protected straight away
  • If after 7 days- condoms for 7 days
  • Can have local anaesthetic to help with pain
  • Checking its still in place by feeling for 2 thin threads that hang down from your womb into the top of your vagina
  • Can be taken out at any time and possible to get pregnant
26
Q

important side effects of IUS

A
  • Mood swings
  • Skin problems
  • Breast tenderness
  • Risk of infection
  • Ectopic pregnancy
  • Doesn’t protect against STI
27
Q

benefits of IUS

A
  • For women who can remember to take the pill
  • No impact on fertility
  • Makes periods lighter, shorter or stop
28
Q

the implant MOA

A
  • Implant releases a steady amount of progestogen into bloodstream, which stops ovulation
  • Also thickens cervical mucus
  • Thins lining of the womb
29
Q

indication of implant

A
  • Can be used in women cant use contraception that contains oestrogen
30
Q

contraindication of the implant

A
  • If you are pregnant
  • Don’t want your periods to change
  • Take medication that affects the implant
    • Medicines for HIV, epilepsy and tb
      • Unexplained bleeding in between periods or after sex
      • Breast cancer
31
Q

correct use of implant

A
  • >99% effective
  • Last for 3 years
  • If fitted within first 5 days of menstrual cycle- protected immediately
32
Q

important side effects of implant

A
  • Bruising and swelling when first implanted
  • Headaches, nausea, breast tenderness and mood swings for first few months
  • Acne
  • Doesn’t protect against STI
33
Q

benefits of implant

A
  • For women who can remember to take the pill
  • Fertility returns to normal very quickly
  • amenorrhoea
34
Q

the injection

A

depo-provera mostly given in uk

35
Q

injection MOA

A
  • Progestogen is steadily released into bloodstream and prevents ovulation
  • Also thickens cervical mucus and thins endometrium
36
Q

indication of injection

A
  • Can be used in women cant use contraception that contains oestrogen
37
Q

contraindication of the injection

A
  • If pregnant
  • If you don’t want periods to change
  • Want to have a baby in the next year
  • Unexplained bleeding
  • Risk of osteoporosis
    • Due to suppression of oestrogen
38
Q

correct use of injection

A
  • 99% effective
  • Lasts for 12 weeks
  • Injection in bottom
  • Can be self administered
39
Q

important side effects of injection

A
  • Wight gain
  • Headaches
  • Mood swings
  • Breast tenderness
  • Irregular bleeding
  • Hair loss
  • Decreased sex drive
  • Can take up to a year for fertility to return to normal after injection wears off
  • Doesn’t protect against STI
40
Q

benefits of injection

A
  • For women who can remember to take the pill
  • Not affected by other medicines
  • May reduce heavy, painful periods
41
Q

women who have a past history of breast cancer should

A

not be on hormonal contraception

  • only appropriate long term contraception is IUD
42
Q

vasectomy

A

Is a surgical procedure to cut or seal the tubes that carry a man’s sperm to permanently prevent pregnancy.

  • >99% effective
  • Permanent- very difficult to reverse and not on the NHS
  • Doesn’t affect sex drive
  • Counselling before operation
  • Safer and simpler to female sterilisation
  • Often only done in those >30
43
Q

how a vasectomy works

A
  • Stopping sperm getting into semen by cutting the vas deferens (removing a small section and then the ends are closed by tying them or sealing them using heat
  • 2 types of vasectomy
    • Scalpel (surgical)- conventional
    • Non-scalpel
  • Need to use contraception for 8-12 weeks after operation because sperm will still be in the tubes
  • Up to 2 semen test done after operation to make sperm have gone
  • At 12 weeks sample of semen tested for sperm
44
Q

sterilisation

A

Female sterilisation is an operation to permanently prevent pregnancy. The fallopian tubes are blocked or sealed to prevent the eggs reaching the sperm and becoming fertilised.

  • >99% effective
  • Does not affect hormone levels and you still have periods
  • Reversal is not available on the NHS
  • Counselling before operation
45
Q

how sterilisation works

A
  • Fallopian tubes sealed preventing eggs travelling down to be fertilised
  • Eggs will still be released from the ovaries as normal, but they’ll be absorbed naturally into the woman’s body.
  • Methods:
    • Applying clips
    • Applying rings
    • Tying, cutting and removing
  • If blocking tubes hasn’t work, tubes can be removed- salpingectomy
  • Often done under general anaesghetic
46
Q

advice after sterilisation

A
  • If you have had tubal occlusion, use additional contraception until first period to protect yourself from pregnancy
47
Q

Adverse outcomes for sterilisation

A
  • Internal bleeding
  • Infection
  • Damage to other organs
  • May not work and increased risk of ectopic pregnancy
  • Non reversible
  • Doesn’t protect against STI
48
Q

Fertility awareness method

A

Involves monitoring and recording fertility indicators throughout the cycle

e.g. cervical secretions, changes in your cervix, basal body temp

49
Q

when you ar emost fertile

A
  • cervical secretions are wetter, transparent, slippery and most stretchy
  • basal body temp increases slightly after ovulation (36.1 to 36.4 whereas after ovulation it rises between 36.4 – 37)
50
Q

advantages of fertility awareness method

A
  • no hormones involves
  • can be up 99% effective if followed very carefully
51
Q

disadvantages of fertility awareness method

A
  • time consuming, unreliable, no STI protection
52
Q

post-cotial contraception

A

Two types of emergency contraception

  • Emergency contraceptive pill – levonelle or ellaOne
  • The IUD
53
Q

indication of post-coital contraception

A

Indication: unprotected sex, forgot to taker regular contraceptive, late having implant or injection

54
Q

emergency contraceptive pill: MOA of levonelle

A

within 3 days (72hours) of unprotected sex

  • Contains levonorgestrel a synthetic version of progesterone
  • Stops or delays ovulation
55
Q

emergency contraceptive pill: MOA of ellaOne

A

within 5 days (120 hours)

  • contains ulipristal acetate- stops progesterone working normally
  • stops or delays ovulation
56
Q

Indications and contraindications morning after pill

A
  • most women can take it (levonelle is even safe to take whilst breast feeling)
  • contraindications
    • e.g. medicine for epilepsy, HIV or TB
57
Q

side effects of morning after pill

A
  • Headache
  • Tummy pain
  • Change to next period
  • Feeing or being sick (get medical attention if you’re sick within 2hours of taking levonelle or 3 hours of taking ellaOne
58
Q

the IUD as a post-coital contraception

A
  • Can be fitted up to 5 days after unprotected sex or up to 5 days after the earliest time you could have ovulated
  • More effective than the pill
59
Q

Presentation of menorrhagia

A
  • need to change your pad or tampon every 1 to 2 hours, or empty your menstrual cup more often than is recommended
  • need to use 2 types of sanitary product together, such as a pad and a tampon
  • have periods lasting more than 7 days
  • pass blood clots larger than about 2.5cm (the size of a 10p coin)
  • bleed through to your clothes or bedding
  • avoid daily activities, like exercise, or take time off work because of your periods
  • feel tired or short of breath a lot

GP block (Y3) (39 decks)

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