13005504
Description
Flashcards by Ashutosh Kumar, updated more than 1 year ago
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Created by Ashutosh Kumar
about 6 years ago
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| Question | Answer |
| COCP Pros: Cons: Contraindications: Instructions: | Pros: - 99% effective - Regular withdrawal bleeds (usually lighter and less uncomfortable than normal bleeds) - May reduce risk of future ovarian and endometrial cancer Cons: - Does not protect against STIs - Taken daily, ideally at the same time, to be effective - Increased risk of VTE Contraindications: - Hx of migraine with aura - Current or past VTE or known thrombogenic mutation - Valvular and congenital heart disease - BMI>40 Instructions: You will not be safe unless you have taken 7 hormone pills in a row. Use another method of contraception such as condoms whilst taking the 7 hormone pills. If the condom breaks or slips off, you will need an ECP. If there are less than 7 hormone pills left in the pack, finish the hormone pills and start the neck pack immediately (miss the 7 inactive pills or 7 day break). If you get severe diarrhoea or vomit for a week or more, you should follow the 7 day rule. |
| Progesterone only pill Pros: Cons: Contraindications: | Pros: - 96-99% effective - Serious adverse events rare - Decreased risk of ectopic pregnancy Cons: - Does not protect against STIs - Must be taken at the same time every day (increased risk of pregnancy if taken >3 hrs late) - May cause irregular bleeding or spotting - May cause adverse adrenergic symptoms Contraindications: - Current VTE - Discontinue if migraine with aura develops after initiation |
| Intrauterine contraceptive device (IUCD) Pros: Cons: Contraindications: | Pros: - 99% effective - Can stay in place for 5 or more years - No hormones - Can be used to prevent pregnancy after unprotected sexual intercourse - Fully funded Cons: - Does not protect against STIs - Increased risk of infection (1%) during insertion- prior screening for infection and Rx necessary - May cause increased bleeding and cramping during a period - May cause pain during insertion or removal - Insertion may be difficult in young adolescents who have never had a vaginal Ex - Device more likely to be expelled in nulliparous women - Risk of vasovagal or cervical shock Contraindications: - Current chlamydia, gonorrhea, purulent cervicitis or PID- use not recommended if very high likelihood of exposure to gonorrhoea or chlamydia infection - Unexplained vaignal bleeding - Uterine cavity abnormality |
| Levonorgestrel intrauterine system (LNG-IUS)- Mirena Pros: Cons: Contraindications: | Pros: - >99% effective - Can stay in place for five years - After approximately 1 year periods are lighter or absent Cons: - Does not protect against STIs - Currently unfunded unless specific criteria met (heavy menstrual periods and ferritin <16 mcg/L) $300 - Increased risk of pelvic infection during insertion so screen and Rx beforehand - May cause adverse androgenic symptoms such as acne, weight gain, mood changes - May cause pain during insertion or removal - Insertion may be difficult in young adolescents who have never had a vaginal Ex - Risk of vasovagal or cervical shock Contraindications: Current chlamydia, gonorrhea, purulent cervicitis or PID- use not recommended if very high likelihood of exposure to gonorrhoea or chlamydia infection - Unexplained vaignal bleeding - Uterine cavity abnormality - Current VTE - Discontinue if migraine with aura develops |
| Long-acting implantable progestogen (reversible) contraceptives e.g Jadelle, Implanon Pros: Cons: Contraindications: | Pros: - >99% effective - Jadelle (2 rods) lasts up to 5 years (funded) - Implanon (1 rod) lasts up to 3 years - Can be removed at any time and the effects are fully reversible Cons: - Does not protect against STIs - Involves minor surgery (with LA) to place or remove rod(s) under the skin of the upper arm - Menstrual irregularities are frequently reported - May cause adverse androgenic symptoms - Implanon not funded ($380) - Insertion and removal of rods may incur additional costs Contraindications: - Current VTE - Discontinue if migraine with aura develops |
| Progestogen injectable: Depot medroxyprogesterone acetate Pros: Cons: Contraindications: | Pros: - Almost 99% effective - Lasts 12 weeks - Reduces the risk of endometrial cancer - May decrease pre-menstrual syndrome - May be useful for girls who have heavy or painful periods- amenorrhea occurs in half of all users in the first year - Fully funded Cons: - Does not protect against STIs - Theoretical concern that optimal peak bone density not achieved in adolescents - May initially cause irregular or prolonged bleeding (Rx by having COC for 1 month or next injection earlier) - May cause adverse androgenic symptoms - Return to fertility after discontinuation delayed for 6-8 months (but can be up to 18 months) Contraindications: - Second line in young adolesecents - Current VTE - Discontinue if migraine with aura develops |
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