Contraception
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- Created by: SamDavies
- Created on: 16-05-19 01:49
What are the types of short-acting contraceptives?
Oral contraception (COC or POP), combined hormonal patch, combined hormonal ring
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What are the types of long-acting contraceptives?
Injectable, implant, intrauterine system and device (IUS or copper IUD)
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What are the types of barrier methods?
Condoms, diaphragm, caps and spermicides
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What does the periodic abstinence/natural family planning contraception involve?
Monitoring calender cycle, ovulation, symptothermal, hormones
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What forms of sterilisation are there?
Bilateral tube ligation (female) and vasectomy (male)
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How does the combined oral contraceptive (COC) work?
Through negative feedback, the oestrogen and progestogen decrease the secretion of FSH and LH (FSH stimulates follicular maturation and LH needed for ovulation). Also thickens cervical mucus, thins endometrium
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What are monophasic COC pills?
The COC contains fixed amounts of oestrogen and progestogen. 21 tablets in each pack. One is taken every day for 21 days and during the next 7 days the female can have a withdrawal bleed. Can be monophasic 28 day tablets (7 placebo tablets)
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What are phasic COC pills?
These contain varying amounts of oestrogen and progestogen. Used in women who have breakthrough bleeding with monophasic products
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Missed pill advice
A missed pill is one that is more than 24 hrs late. If 2+ tablets are missed in first 7 days use additional contraception for 7 days and consider emergency contraception if she has had intercourse
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Missed pill advice (2)
If she misses two or more tablets in the second 7 days then it will not be necessary to use emergency contraception – this week is not as important as the first week as the ovaries have already been suppressed
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Missed pill advice (3)
If she misses two or more tablets in the final 7 days then she should omit the pill-free week and carry on taking the tablets from the next pack.
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Disadvantages of COC pills?
Risk of venous thromboembolism, no protection against STIs, not suitable for those with a history of CVD
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Combined contraceptive patch (Evra)
Self-adhesive patch to be applied to clean, dry, non-hairy skin – typically the upper outer arm, abdomen, buttock and upper back (location should be changed regularly). The patch is changed every 7 days for 3 weeks with a drug-free 7 day interval
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Disadvantages of the patch?
Similar to COC, drug interactions, no protection against STIs, less effective in women weighing >90kg, application site reactions
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Combined contraceptive vaginal ring
Contains ethinylestradiol 2.7mg & etonogestrel 11.7mg. Inserted for 21 days and removed for 7 days, allowing for a withdrawal bleed. Same risks and benefits as COC but cycle control is better & breakthrough bleeding less common
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How do progestogen only contraceptives work?
Thickens cervical mucus, thins the endometrium and reduces receptivity to implantation, can suppress ovulation. Useful for women who can't tolerate oestrogens
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Progestogen only pills
28 day pills and very important these are taken at the same time each day - preferably a 3 hour window. Only one pill can be missed
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What are the advantages of progestogen only pills?
No oestrogen so suitable in VTE, migraine, high BP, older, smokers. Well tolerated and can use when breastfeeding
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Progestogen implants
A single 40mm rod, 2mm in diameter inserted in the arm. Remove within 3 years. Inhibits ovulation by preventing LH surge and thickens cervical mucus. Can disrupt menses
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Copper IUD
Small t shaped device inserted into the uterus which releases copper to thicken cervical mucus and stop fertilised egg implantation. Periods can be longer, painful and heavier.
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IUS
Small t shaped device inserted into the uterus which releases progestogen. Causes lighter, shorter periods. Thickens cervical mucus and thins endometrium
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What are complications of IUDs and IUS?
Risk of expulsion, perforation, pelvic infection, pregnancy
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What can be used as emergency contraception?
Copper IUD up to 5 days following UPSI; levenorgestrol (progestogen) up to 72 hrs after UPSI but effectiveness declines each day; ellaOne up to 120 hrs after UPSI
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What do umbrella pharmacies tier 1 offer?
EHC, condoms, collection of STI kits
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What do umbrella pharmacies tier 2 offer?
Tier 1 PLUS COC, POP, injectable progestogen, antibiotics for chlamydia (azithromycin or doxycycline)
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Other cards in this set
Card 2
Front
What are the types of long-acting contraceptives?
Back
Injectable, implant, intrauterine system and device (IUS or copper IUD)
Card 3
Front
What are the types of barrier methods?
Back
Card 4
Front
What does the periodic abstinence/natural family planning contraception involve?
Back
Card 5
Front
What forms of sterilisation are there?
Back
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