What are some absolute contra-indications for the COCP?
- migraine with aura
- Breast feeding < 6 weeks post partrum
- Age 35 or over smoking 15 or more a day
- SBP 160 or DBP 96
- vascular disease Hx
- Current or presvious VTE
- Major surgery with immobilisation
- IHD
- nephro/retino/neruopathy
How does the implant work?
steady release of progesterone into the body preventing ovulation
also thickens cervical mucous making it harder for sperm to enter the uterus
also thins the endometrium making it harder for a fertilised egg to implant
What are some reasons for using contraception?
- control fertility preventing unwanted pregancy
- family spacing
- maintain continued reduction in teenage pregnancy rates
- reduce abortion rates
What are some advantages and disadvantages of the hormonal implant?
Advantages:
- works for up to three years
- doesn’t interupt sex
- useful if oestrogen products are contraindicated
- safe whilst breast feeding
- fertility returns immediately afetr removal
- may reduce heavy painful periods
Disadvantages:
-may experience side effects for the first few months - mood swings, breast tenderness, nausea and headaches
- may cause irregular periods
- doesn’t protect from STIs
- small procedure to get it fitted
How does an IUD work?
- Interuterine devide is a small T shaped plastic and copper device
- it releases copper into the uterus which is toxic to sperm prevents implantation and sperm transport
- Can last between 5 or 10 years
What are some advantages and disadvantages of the IUD?
Advantages:
- works straight away once fitted
- can be used as emergency contracpetive
- no hormonal side effects
- safe to use whilst breast feeding
- doesn’t interupt sex
- most women can use it
- works for a long time
Disadvantages:
- Doesn’t protect against STIs
- May cause periods to become heavier, longer and more painful, though this may resolve within months
- can perforate womb on insertion m
- can cause infection upon insertion that if left untreated can lead to PID
- can be expelled by womb
- small risk of ectopic pregancy
How does the interuterine system work?
- The IUS is a small plastic T shape device that locally releases progesterone for between 3-5 years (mirena)
- thickens cervical mucous, thins endometrium and for some women prevents ovulation but not everyone.
What are some advantages and disadvantages of the IUS?
Advantages:
- works for a long time
- doens’t interupt sex
- most effective form of contraception
- periods can become ligher, shorter and less painful - they may stop altogether after the first year
- can become pregnant straight away after removal
- safe on breast feeding
- good if can’t take oestrogen
Disadvantages:
- doens’t protect against UTI
- periods may become irregular
- Side effects of headaches, breast tenderness and acne.
- infection on insertion may lead to PID
- may cause fluid filled cysts on ovaries
How does the Depo injection work?
- releases progesterone into the blood stream over 13 weeks
- Prevents ovulation primarily
- causes mucous thickening and thins the endometrium
What are some advantages and disadvanatages of the contraceptive injection?
Advantages:
- each injection lasts 8-13 weeks so doesn’t interupt sex
- Don’t have to remember to take a pill everyday
- good if can’t take oestrogen
- safe whilst breast feeding
- may reduce heavy painful periods and may help with premenstrual Sx in some women
Disadvantages:
- Doesn’t protect against STIs
- periods may become irregular
- Some people can put on weight
- may up to one year before periods and fertility normalises post withdrawal of injection
- may experience headaches, acne, hair loss, decreased sex drive and mood swings
- Side effects can continue as long as the injection lasts (8-13 weeks) or longer!
What are some causes of teenage pregancy?
obviously it’s sex
- poor sexual education/health
- absent parents
- glamorisation of pregnancy
- sexual abuse/rape
- teenage drinking
What problems will a teenage mother face?
- health risks for the baby - low birth weight inadequate nutrition
- increased risk of medical complications during pregancy
- premature labour
- social impact - leaving educaiton early & stigma & difficulty supporting the child (emotionally, physically, financially)
What are some intervention for preventing teenage pregancy?
- Make condoms more widely available
- better sex education
- encourage family communication around sex
What are some risk factors for safeguarding issues when dealing with children having sex?
- under 13s CANNOT consent to any sexual acitivity in any circumstance
- poor living conditions
- not attending school
- siblings involved with social services
- nature of the relationship they’re involved in
- wheteher overt bribery was involved
- whether the partner is known sex offender
- whether the child denies or minimises the concerns by professionals
- disabled children more at risk
