Contraception Flashcards

1
Q

When do you need to apply more spermicide to a

diaphragm/cap

A

If you have sex again
OR
If you’ve had it in for more than 3 hours

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2
Q

How long after sex do you need to leave the diaphragm/cap in for

A

At least 6 hours

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3
Q

What is the max length of time you can leave a diaphragm/cap in for

A

30 hours

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4
Q

How long after giving birth do you have to wait before using a diaphragm/cap

A

6 weeks

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5
Q

Things that may mean the diaphragm/cap isn’t suitable

A

Latex or spermicide allergy
Recurrent UTIs
Unusual position/shape of cervix
Vaginal infection

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6
Q

Possible side effects/risks of the combined oral contraceptive pill

A
Mood swings
Nausea
Breast tenderness
Headache
DVT
Cervical cancer
STIs not protected against
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7
Q

How does the COCP work

A

Inhibits ovulation
Thickens cervical mucus
Thins endometrium

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8
Q

What counts as a missed pill for the COCP

A

More than 24 hours since you should have taken it

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9
Q

Rules if you miss 1 COCP

A

Take it as soon as you remember, continue as normal

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10
Q

Rules if you miss 2 COCP

A

Take the last one you missed as soon as you remember
Use condoms for 7 days
If there was less than 7 left in your pack skip your pill free break
If you missed it in the first 7 days of the packed and had unprotected sex in the pill free break or since you may need emergency contraception

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11
Q

Advice regarding the COCP if you get vomiting or diarrhea

A

If you vomit within 2 hours of taking the pill then take another one
If you’re been sick lots then use condoms until you’ve managed to keep your pill down for 7 days
If you’re having 6-7 watery stools a day then use condoms while you have diarrhea and for 2 days after its stopped

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12
Q

Contraindications to the COCP (or patch)

A
Age >35 and smoker (or stopped less than 1 year ago)
BMI 35+
Hx of DVT/PE
Hx of stroke/MI
FH of VTE age < 45
HTN
Migraines with aura
Hx of breast cancer
DM with complications
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13
Q

Advice about COCP after having a baby

A

Start taking it 3 weeks after (start it ON day 21)
If its been more than 3 weeks since giving birth you’ll need to use condoms for 7 days as well
If breastfeeding need to wait 6 weeks after birth

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14
Q

Pros of the COCP

A

Can make periods more regular, lighter and less painful
Can reduce PMS
Can reduce acne
Reduces risk of ovarian, uterine and colon cancer

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15
Q

Cons of the COCP

A

Side effects - headaches, nausea, breast tenderness, mood swings (but all usually go away after a few months)
Can increase BP
Doesn’t protect against STIs
Breakthrough bleeding and spotting common at first
Has been linked to an increase risk of VTE, cervical cancer and breast cancer

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16
Q

Medications that can interact certain contraceptives

A

Rifampicin and Rifabutin
Antiepileptics
St Johns Wort
Antiretrovirals

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17
Q

Barrier contraception options

A

Male condoms
Female condoms
Diaphragm/cap

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18
Q

How long does the contraceptive implant last for

A

3 years

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19
Q

Advice about having the contraceptive implant after birth

A

Any time
If < 3 weeks after giving birth you’re immediately protected. If > 3 weeks after giving birth you need to use condoms for 7 days
Its safe in breastfeeding

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20
Q

Contraindications to the contraceptive implant

A

Unexplained IMB or PCB
Hx of heart disease or stroke
Liver disease
Hx of breast cancer

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21
Q

How long does the contraceptive injection last for

A

13 weeks

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22
Q

What are the rules regarding which day of your cycle you start the contraceptive injection/implant/COCP/patch on

A

If its within the first 5 days of your cycle you’re immediately protected. If its > 5 days into your cycle you’ll need to use condoms as well for 7 days

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23
Q

Advice about having the contraceptive injection after giving birth

A

Can be started any time
If within the first 21 days you’re immediately protected
If > 21 days then you need to use condoms for 7 days

24
Q

Contraindications for the contraceptive injection

A
Wanting a baby within the next year
Unexplained IMB or PCB
Hx of heart disease or stroke
Liver disease
Breast cancer
Risk of osteoporosis
25
Q

What counts as a missed pill for POP

A

More than 3 hours late (or 12 hours if Desogestrel)

26
Q

Advice regarding What are the rules regarding which day of your cycle you start the POP on

A

If within the first 5 days you’re protected straight away

If >5 days (or you have a shorter cycle) then need to use condoms for the first 2 days taking the pill

27
Q

Advice about starting the POP after giving birth

A

Can be started any time

If its been more than 3 weeks since giving birth you’ll need to use condoms for 2 days as well

28
Q

Advice regarding missed pills for POP

A

Take 1 when you remember and 1 at the usual time

Use condoms for 2 days or dont have sex for 2 days

29
Q

How does the POP work

A

Mainly by thickening cervical mucus. Some also stop ovulation.

30
Q

Advice for POP when you vomit or have diarrhoea

A

If vomit within 2 hours of taking it then just take another one
If >3 or >12 then treat it as a missed pill (i.e. take another and use condoms for 2 days)
If continually ill then use condoms while you’re ill and for 2 days after
If 6-8 watery stools a day then use condoms while you’re ill and for 2 days after recovering

31
Q

Contraindications to the POP

A

Unexplained IMB or PCB
Arterial/heart disease or stroke
Liver disease
Breast cancer

32
Q

Ovarian cysts are a risk associated with which contraceptive

A

POP

33
Q

How long does the contraceptive patch last for

A

1 week

You change it every week for 3 weeks then have a weeks break

34
Q

Advice for if the contraceptive patch comes off

A

If its been off for <48 hours and it had already been on for 7 days then just stick it back on and you’re protected straight away
If its been off for > 48 hours or if it hadn’t already been on for 7 days then stick another on and use condoms for 7 days

35
Q

Advice regarding which day of the cycle to start using the vaginal ring

A

If you insert it on day 1 then you’re protected. If its on any other day of the cycle you need to use condoms for 7 days as well

36
Q

How long does the contraceptive vaginal ring last for

A

21 days

You leave it in for 21 days, have a 7 day break then insert a new one

37
Q

Advice regarding the contraceptive vaginal ring after giving birth

A

Can use it 3 weeks after (ON day 21)
If its later than day 21 use condoms for 7 days
Don’t use if breastfeeding <6 months (can reduce flow of milk)

38
Q

How long does the IUD last for

A

5-10 years

39
Q

How long after insertion of the IUD are you protected

A

Straight away

40
Q

How long after IUD insertion is a follow up

A

3-6 weeks

41
Q

Contraindications to IUD

A

Untreated STI or PID
Problems with cervix or uterus
Unexplained IMB or PCB

42
Q

How soon after birth can the IUD be fitted

A

Either within the first 48 hours - if not then after 4 weeks

Safe in breastfeeding

43
Q

How long does the IUS last

A

3-5 years

44
Q

Which contraceptives are progesterone only

A

POP
Injection
Implant
IUS

45
Q

Which contraceptives are combined hormones

A

COCP
Vaginal ring
Patch

46
Q

Advice regarding which day of the cycle you have the IUS fitted

A

If within the first 7 days then protected straight away

If > 7 days then need to use condoms for 7 days

47
Q

If women are going to have their IUD/IUS removed, what is important to tell them if they don’t want to get pregnant

A

Need to start using condoms 7 days before you get it removed if you’re not having another one put in straight away

48
Q

Contraindications to the IUS

A
Breast cancer
Cervical cancer
Endometrial cancer
Liver disease
Unexplained IMB or PCB
Arterial/heart disease or stroke
Untreated STI or PID
Problems with cervix or uterus
49
Q

How long after birth can the IUS be fitted

A

Within 48 hours or after 4-6 weeks

Safe in breastfeeding

50
Q

If a women has given birth and wants the IUD/IUS inserted after 4 weeks, what do advice her regarding contraception in the meantime

A

21 days after birth you need to start using contraception until the IUD/IUS can be fitted

51
Q

Risk of infection is highest within how many days of IUD/IUS insertion

A

The first 20 days

52
Q

Which contraceptives can increase the risk of ectopic if you do become pregnant on them

A

IUD and IUS

53
Q

Which forms of contraception can be used as soon as you want after giving birth

A
Male condoms
Female condoms
Implant
Injection
POP

IUD + IUS (if within 48 hours - if missed this window need to wait until its been 4 weeks)

54
Q

Which contraceptives can’t be used until 6 weeks after giving birth if you’re breastfeeding

A

COCP
Vaginal ring
Patch

Also have to wait 6 weeks to use the diaphragm/cap but its safe to breastfeed

55
Q

Which contraceptives do you have to wait 3 weeks before using after giving birth

A

COCP
Vaginal ring
Patch
(All of which you can’t use until 6 weeks if you’re breastfeeding, but fine to use at 3 weeks if you’re not)

56
Q

Which contraceptives are safe in breastfeeding

A
Condoms
Implant
Injection
POP
IUS
IUD
Cap