Women's health - contraceptives

Question 1

best contraception for heavy bleeding and menorrhagia

Answer 1

hormonal IUD (minera)

Question 2

contraception that takes up to 6 months to wear off

Answer 2

depot-provera injection

Question 3

what contraceptives are safe after pregnancy

Answer 3

implanon and minipill

Question 4

what are the benefits of COCP?

Answer 4

helps with acne and hirsutism
prevents onset of osteoporosis
makes period lighter and less painful
allows skipping of period - better control
prevents against endometriosis and uterine fibroids
decreases chance of uterine and ovarian cancer

Question 5

what are the absolute contraindications of COCP

Answer 5

> 35 and smoking history > 15 cig a day
previous history of VTE/PE
previous history or active history of breast CA
previous history of IHD/CVS/CVA diseases
hypertension of >160/100
valvular heart disease
severe liver cirrhosis and liver adenoma

Question 6

what are the risks of COCP?

Answer 6

increased risk of breast CA and endometrial CA

increased risk of VTE/PE

Question 7

what are the side effects of COCP?

Answer 7

spotting
oedema
n/v

Question 8

what happens if patient misses the COCP?

Answer 8

less than 24: just take as per normal as they remember
more than 24: take as soon as remember, use protection for next 7 days of intercourse
if any of the pills taken in the last 7 days were sugar pills and had sex in the last 5 days = use emergency contraceptives

Question 9

what factors may stop COCP from working as it should?

Answer 9

severe diarrhoea/vomiting
use of st john’s wort
antibiotics use and anti-epileptics use

Question 10

what are the advantages of using implanon?

Answer 10

can be used immediately after pregnancy
safe to use in pregnancy
does not contain oetrogen

Question 11

what is the effectiveness of COCP?

Answer 11

91%

Question 12

what are the side effects of implanon?

Answer 12

hormonal effects: mood swinging, weight gain, bloating, sore breasts,
bleeding; may be irregular, may be heavy

Question 13

what are the contraindications of implanon, depot provera and hormonal IUD?

Answer 13

5 years past history of breast CA

Question 14

what are the advantages of using depo provera injections

Answer 14

private, cost effective, does not require pills
does not have oestrogen side effects
safe for breast feeding, requires 6 months before use after pregnancy

Question 15

what is the most effective reversible method of contraception?

Answer 15

implanon (99.9%)

Question 16

what are the side effects of using depo provera injections

Answer 16

irregular bleeding in 1st 3 - 4 months
hormone related hormonal effects: weight gain, mood swings, bloating, sore breasts
long term use may be assoc. w/ osteoporosis

Question 17

what are the disadvantages of mini pill?

Answer 17

only allows 3 hour leeway each day

may have irregular unpredictable bleeding

Question 18

what may affect effectiveness of mini pill?

Answer 18

severe diarrhoea, vomiting
saint john’s wart
antibiotics/antiepileptics

Question 19

what are the advtanges of hormonal IUD (Mirena)

Answer 19

ideal for women with heavy periods
does not cause weight gain
can be left in till menopause occurs

Question 20

what is an absolute contraindication to IUD?

Answer 20

presence or risk of SIT - lead to complication of PID

Question 21

what procedures must be done before and after placement of IUD?

Answer 21

before screen; STI screen and pregnancy screne

after; no sexual intercourse, swimming or use of tampons in the next 48 hours

Question 22

what are the disadvantages of using IUD/

Answer 22

uncomfortable inserting procedure
chance of infection causing PID
may be expelled in the first 3 months
can only be used 6 months after pregnancy