Progesterone only contraception + others

what is the progestogen only pill also known as and what does it contain

the mini pill, contains levo and nore

what should the mini pill be taken

Active pills are taken everyday for 28 days

when is contraception established for the mini pill

Immediate contraception established if taken within the first 5 days of period

what is the main advantage of the mini pill over COC?

much lower risk of VTE, used for contraception in breast feeding women

The mini pill is contraindicated in: ___ cancer, Acute ___, Severe ____, L__ C__, Less than ___ weeks P_

Breast, DVT/PE, Cirrhosis, Liver Cancer, 3, Postpartum

When should the mini pill be taken

Same time each day, should not be more than 3 hours late. If started after day 5 of cycle, use other method of contraception for 48hrs

What to do if you have missed a progesterone only pill

Take pill asap. Take next pill as usual. Use barrier for 48 hrs. Consider EC if intercourse occurred before 3 consecutive pills have been taken

What hormone does the implant release

releases etonogestrel

every _ years replace the rod

3

when does the rod establish contraception

if inserted on days 1-5 of cycle- immediately effective, otherwise additional contraception required for 7 days

adverse effects for the rod

bruising, pain, itching with insertion, otherwise changes in bleeding patterns always occur. Should be able to feel the implant under the skin

If frequent bleeding with the rod, what do we add?

estrogen alone or COC or Mefanamic acid 500mg bd for 5 days

what is the DMPA dose

150mg given intramuscularly every 12 weeks

what are the contraindications to DMPA injection

Breast cancer , DVT/PE, Severe Cirrhosis, Liver Cancer, Less than 3 weeks Postpartum

the DMPA injection have considerations for ___

osteoporosis as it can decrease Bone mineral density- make sure they have a good intake of calcium

what is another consideration of the DMPA injection

weight gain and return of periods may take 6 months

how long does an IUD stay in the uterus for?

5 years

How does the Levo IUD work

Contains a reservoir in the stem that slowly releases levonorgestrel. Immediate contraception if inserted during first 7 days of menstruation. Needs 7 days of barrier if inserted later

What is the most common symptom of IUD

spotting in the first 3-5 months

What is the main benefit of levo IUC

No delayed return of fertility following removal

What contraception to avoid in breastfeeding

COC’s, oestrogen can decrease lactation

When should IUD’s NOT be used post partum

less than 6 weeks

When someone has migraines, which contraception do we like to put them on

progesterone only contraception

IUD’s are more often expelled by ___ and ___ women

adolescence, nulliparous (never had pregnancy)

___ will be good for adolescence contraception

Implant due to compliance

What is not a good choice for 40+ y/o women

DMPA injection due to its effects on bone mineral density

what is the EC of choice in BF women

Oral levo (progesterone)

Copper IUD can only be insert in __+ weeks pospartum

4

When is EC required when missing a pill?

when the missed pill is In first 7 active days with unprotected sex in previous 5 days, do not need EC if in middle 7 active days or last 7 active days, but must ensure active pills are taken for 7 days

when is EC required when on the progesterone only pill

If pill is more than 3 hrs late AND unprotected sexual intercourse occured within 48 hrs after missed pill (UPSI before 3 active pills)

When is EC required when on the vaginal ring

when expulsion for longer than 3 hours AND its the first 7 days after ring free period

What are some common adverse effects of oral levonogestrel

nausea, breast tenderness, irregular bleeding

When does a woman have to resume hormonal contraception after taking EC

Take contraception within 12 hours

How does oral levonorgestrel work

delays ovulation. women will still need to use the barrier method for 7 days following EC

What EC would you use if unprotected sex for previous 72 hrs

Ulipristal can be used for shorter than 120 hrs, wait for at least 5 days before recommencing hormonal contraceptive

side effects of ulipristal

nausea, breast tenderness

what is the preferred EC if woman is taking enzyme inducing drugs

Copper IUD

what are some counselling points for EC

It does not provide contraception for the rest of the cycle. If vomiting occurs within 2-3 hrs, needs to be readministered, does not induce withdrawal bleeds, seek medical advice if abnormal bleeding/pain, EC does not cover STI’s

what is the new progesterone pill called

Slinda, containing drosperinone

when should Slinda be taken

24 active hormone pills and 4 inactive pills

When is contraception established for Slinda

Immediately effective if taken during first 5 days of period, if taken after, effective after 7 days of active pills

What is the missed pill window for Slinda (POP)

if they miss a dose greater than 24 hrs from usual dosing time

What to do if you miss a dose of Slinda (POP)

Take missed pill ASAP, Take the next pill at usual time, Throw away the other missed pills, continue taking pills as normal, need to take 7 active pills to reestablish contraception, if there are fewer than 7 days until sugar pills, skip sugar pills and go straight to next packet, use barrier method for 7 days