Notes in OG9.1 Contraception

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Published	10/04/2024	{{c1::Perfect use failure rate}}: {{c2::Number of pregnancies occurring when the method is used consistently and correctly at all times }}
Published	10/04/2024	Typical use failure rate: {{c1::Number of pregnancies occurring when the method is used both correctly and incorrectly, reflecting contraceptive …
Published	10/04/2024	Method of action of combined OCPs:- {{c1::Prevent ovulation }}- {{c1::Inhibit implantation }}- {{c1::Thickens cervical mucus&…
Published	10/04/2024	Combined OCPs perfect use failure rate → {{c1::0.3%::%}}
Published	10/04/2024	Combined OCPs typical use failure rate → {{c1::9%::%}}
Published	10/04/2024	Monophasic 1 day pills, bi/tri-phasic 21 day pills and every day pills are types of {{c1::OCPs}}
Published	10/04/2024	OCPs {{c1::↓}} risk of endometrial cancer
Published	10/04/2024	OCPs {{c1::↓}} risk of ovarian cancer
Published	10/04/2024	OCPs {{c1::↑}} risk of breast cancer
Published	10/04/2024	OCPs {{c1::↑}} risk of cervical cancer
Published	10/04/2024	Major risk of combined OCP use is {{c1::venous thrombosis }}
Published	10/04/2024	The risk of venous thrombosis is {{c1::higher::higher/lower}} with third generation progestogens in combined OCPs than with second
Published	10/04/2024	- Previous thromboembolism or stroke - Age > 35 and a smoker- BMI ≥ 35- Breast cancer- Severe migraine or migraine with aura - Liver dise…
Published	10/04/2024	Nausea, dizziness, breast tenderness and vaginal discharge are {{c1::estrogenic::estrogenic/progestogenic}} side effects of combined OCPs
Published	10/04/2024	Vaginal dryness, acne, loss of libido, mood changes and irregular bleeding are {{c1::progestogenic::estrogenic/progestogenic}} side effects of co…
Published	10/04/2024	Management of estrogenic side effects of combined OCPs → {{c1::Change to a pill with lower estrogen }}
Published	10/04/2024	Management of progestogenic side effects of combined OCPs → {{c1::Change to a newer generation of progestogen}}
Published	10/04/2024	Management of breakthrough bleeding on combined OCPs → {{c1::change to a higher dose estrogen}} or {{c1::triphasic pill }}
Published	10/04/2024	OCPs are metabolized by {{c1::CYP450::liver enzyme group }}
Published	10/04/2024	{{c1::Lamotrigine::Rx}} interacts with combined OCPs and may ↑ seizures
Published	10/04/2024	{{c1::Ullipristal acetate/EllaOne::emergency contraceptive }} may reduce the efficacy of combined OCPs
Published	10/04/2024	The nuva ring contains {{c1::estrogen}} and {{c1::progesterone }}
Published	10/04/2024	The Nuva ring should be used for {{c1::3 weeks }} out of 4 weeks
Published	10/04/2024	The evra dermal patch contains {{c1::estrogen}} and {{c1::progesterone }}
Published	10/04/2024	Mode of action of the progesterone only pill:- {{c1::Inhibits implantation }}- {{c1::↓ cervical mucus penetrability }}- {{c1:…
Published	10/04/2024	{{c1::Desorgestrel::Levonorgestrel/desorgestrel}} inhibits ovulation more than {{c1::levonorgestrel::levonorgestrel/desorgestrel}}
Published	10/04/2024	Indications for the progesterone only pill:- {{c1::Lactation }}- {{c1::Intolerance or contraindications to combined OCPs }}
Published	10/04/2024	Perfect use failure rate of progesterone only pills → {{c1::< 1%::%}}
Published	10/04/2024	Typical use failure rate of progesterone only pills → {{c1::9%::%}}
Published	10/04/2024	The biggest disadvantage to progesterone-only pills is {{c1::it requires compliance down to a 3 hour window}}
Published	10/04/2024	Is there a pill-free interval when using progesterone-only pills?{{c1::No}}
Published	10/04/2024	If you are late by more than {{c1::3 hours}} with the progesterone only pill, you need barrier contraception for the next 7 days
Published	10/04/2024	If pregnancy occurs on the progesterone only pill, there is an ↑ risk of {{c1::ectopic pregnancy }}
Published	10/04/2024	Progesterone only pills frequently cause {{c1::irregular bleeding }}
Published	10/04/2024	The implanon is inserted on day {{c1::1 - 5 }} of the menstrual cycle
Published	10/04/2024	Most reliable female contraception → {{c1::implanon }}
Published	10/04/2024	Failure rate of implanon → {{c1::0.05%::%}}
Published	10/04/2024	Implanon can be left in up to {{c1::3 years }}
Published	10/04/2024	Mode of action of implanon:- {{c1::Inhibits ovulation in 80% }}- {{c1::thickens cervical mucous }}- {{c1::Prevents implantati…
Published	10/04/2024	Active ingredient of implanon → {{c1::etonorgestrel (synthetic progestogens)}}
Published	10/04/2024	Implanon causes {{c1::progestogen::estrogen/progestogen }} like side effects
Published	10/04/2024	Is there a delay in return of fertility upon removal of implanon?{{c1::No}}
Published	10/04/2024	Depo-provera is given every {{c1::12 weeks}}
Published	10/04/2024	Depo-provera injection has the same mechanism of action as {{c1::implanon }}
Published	10/04/2024	Depo-provera injection is a good option for women who find it difficult to {{c1::remember to take the pill }}
Published	10/04/2024	Depo-provera injection is useful if {{c1::estrogen }} is contraindicated
Published	10/04/2024	Depo-provera injection is useful during {{c1::lactation }}
Published	10/04/2024	Side effects of depo-provera:- {{c1::Irregular bleeding }}- {{c1::Amenorrhoea }}- {{c1::Weight gain up to 2 - 3 kg/year …
Published	10/04/2024	Depo-provera takes  {{c1::6 months-1 year::range}} for a return to fertility
Published	10/04/2024	Long term use of depo-provera (> 2 years) can lead to {{c1::decreased bone density }}
Published	10/04/2024	Perfect use failure rate of depo-provera → {{c1::0.2%::%}}
Published	10/04/2024	Typical use failure rate of depo-provera → {{c1::6%::%}}
Published	10/04/2024	Failure rates of levonorgestrel releasing IUDs → {{c1::< 0.2%::%}}
Published	10/04/2024	Mechanism of action of levonorgestrel releasing IUDs:- {{c1::Thickens cervical mucus }}- {{c1::Thins endometrium }}- {{c1::Lo…
Published	10/04/2024	Explusion risk of IUDs → {{c1::5%::%}}, most common in the first year
Published	10/04/2024	Mirena coil is also used for (non-contraceptive uses):- {{c1::Menorrhagia }}- {{c1::Dysmenorrhoea }}- {{c1::To oppose estroge…
Published	10/04/2024	Side effects of mirena/jaydess:- {{c1::Amenorrhea (20%) }}- {{c1::Irregular bleeding for up to 6 months }}- {{c1::Transient P…
Published	10/04/2024	If conception occurs on mirena or jaydess, there is an ↑ risk of {{c1::ectopic pregnancy }}
Published	10/04/2024	- Pregnancy - Pelvic inflammatory disease - Current STI- Uterine/cervical malignancy - Distorted uterine cavity - Cardiac disease …
Published	10/04/2024	Mechanism of action of copper IUD → {{c1::Toxic effect on sperm and ova, and causes local inflammatory reaction }}
Published	10/04/2024	Copper IUDs can be used for {{c1::5-10 years::range}}
Published	10/04/2024	Failure rate of copper IUDs → {{c1::0.6%::%}}
Published	10/04/2024	{{c1::Copper}} IUDs are a good long term option for women with a history of breast cancer, or who are using enzyme inducing drugs
Published	10/04/2024	Major drawback of copper IUD is → {{c1::Menorrhagia }}
Published	10/04/2024	- Pregnancy- Current STI or PID- Copper allergy - Wilson's disease - Heavy periods - Cardiac diseaseThese are contraindications to…
Published	10/04/2024	Perfect use failure rate of condoms → {{c1::2%::%}}
Published	10/04/2024	Typical use failure rate of condoms → {{c1::18%::%}}
Published	10/04/2024	Levonelle and norlevo are {{c1::emergency contraception }}
Published	10/04/2024	Levonelle and norlevo are licenced for use for up to {{c1::72h }} after unprotected sex
Published	10/04/2024	If pregnancy occurs while taking levonelle or norlevo, there is an ↑ risk of {{c1::ectopic pregnancy }}
Published	10/04/2024	The active ingredient in EllaOne is {{c1::Ullipristal acetate (progesterone receptor modulator)}}
Published	10/04/2024	Ella one is licenced for up to {{c1::120h }} after unprotected sex
Published	10/04/2024	EllaOne can only be used {{c1::once }} per cycle
Published	10/04/2024	EllaOne reduces the efficacy of {{c1::COCPs }} and {{c1::progesterone only pills }}
Published	10/04/2024	Contraindications for EllaOne:- {{c1::PPI/H2 receptor agonist use }}- {{c1::Severe asthma }}- {{c1::Liver disease }}-&nb…
Published	10/04/2024	Copper IUD can be used as emergency contraception up to {{c1::5 days }} after unprotected sex or within {{c1::5 days}} of earliest esti…
Published	10/04/2024	Prior to using copper IUD as emergency contraception, give prophylaxis for {{c1::chlamydia }}
Published	10/04/2024	Risk for regret for female sterilization:- {{c1::< 30 years old }}- {{c1::Nulliparous }}- {{c1::Recent pregnancy }}-&…
Published	10/04/2024	Tubal ligation failure rate {{c1::1:200::ratio}}
Published	10/04/2024	If pregnancy occurs after tubal ligation, there is a 10% risk of {{c1::ectopic pregnancy}}
Published	10/04/2024	{{c1::Hysteroscopic tubal occlusion::tubal ligation/hysteroscopic tubal occlusion}} is 100% non-reversable
Published	10/04/2024	Contraindication to hysteroscopic tubal occlusion → {{c1::nickle allergy }}
Published	10/04/2024	Failure rate of vasectomy → {{c1::1:10,000::ratio}}
Published	10/04/2024	Missed pills on COCPif 1 pill missed: {{c1::take asap}}if 2 pills missed in 1st week of pack: {{c2::consider emergency contraception if unprotected se…
Published	10/04/2024	advantages of COCPdecreased risk of {{c1::endometrial, ovarian, colorectal::3}} cancersdecreased menstrual bleeding, painmanages PCOS, endometriosis, …
Published	10/04/2024	disadvantages of COCP{{c1::decreased}} libido{{c1::unscheduled}} bleeding
Published	10/04/2024	if missed 1 progesterone-only pill (> 3 hrs)take {{c1::asap and take remaining at same time}}condoms x {{c1::48}} hours+/- {{c1::emergency contrace…
Published	10/04/2024	The Mirena is inserted in the first {{c1::7}} days of the menstrual cycle to ensure no pregnancy and can stay in for {{c1::8}} years for contrace…
Published	10/04/2024	natural cycle trackinginvolves avoiding unprotected sex during fertile window (day {{c1::7-19::range}} if 28 day cycle)use {{c1::body temp}} and {{c1:…
Published	10/04/2024	barrier contraceptioncondoms: prevents STIs but not {{c1::herpes, genital warts, pubic lice::3}}female diaphragm: need to use {{c1::spermicide}} and r…
Published	10/04/2024	Post-vasectomy semen analysis at earliest {{c1::12}} weeks after to ensure success, use other methods of contraception until then
Published	10/04/2024	Tubal ligation failure rate = 1 in {{c1::200}}through clipping or tying tube
Published	10/04/2024	emergency contraception can be used from day {{c1::21}} after childbirth and day {{c1::5}} after abortion, miscarriage, treatment of ectopic pregnancy
Published	10/04/2024	{{c1::copper coil}} = most effective emergency contraceptive
Published	10/04/2024	Levonelle MOA: {{c1::delays ovulation}}, but not effective if {{c1::ovulation already occurred}}
Published	10/04/2024	Can use Levonelle {{c1::multiple times::once or many times}} in the cyclestart oral contraception immediately after taking
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