Combined oral contraceptive pill counselling PDF

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Summary

Combined oral contraceptive pillOpening consultation - Wash hands and put PPE on - Introduce yourself - Confirm patients name and DOB and how they would like to be addressed - ‘there are many different types of contraception like coils barrier etc’ - ‘why are you wanting the COCP specifically’ICE ‘h...

Description

Combined oral contraceptive pill Opening consultation - Wash hands and put PPE on - Introduce yourself - Confirm patients name and DOB and how they would like to be addressed - ‘there are many different types of contraception like coils barrier etc’ - ‘why are you wanting the COCP specifically’

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‘have you heard of the COCP’ ‘what do you already know about the COCP’ ‘is there anything that worries you about the COCP’ ‘what are you hoping the COCP can do for you’ ‘why do you think the COCP is best choice for you’

What is it? How it works? - It contains oestrogen and progesterone - Which are similar to hormones in ovaries - Stops ovaries from producing egg every month so reduced chances of pregnancy - Thickens mucus around cervix to stop sperm enetering - Also makes lining on womb thinner so fertilsied egg cant be inplanted - Referred to as pill What are different types - Monophasic type – each pill has same amount of hormone so take it for 21 days and 7 day break - Phasic – each pill contains different amount of hormone so the pill must be taken in correct order. Taken for 21 days with 7 day break - Everyday pill – 21 pills and 7 placebo pills. Take everyday without break Check patients understands and do chunck and check Ask patient to repeat information back How effective is it? - It is 99% effective when used correctly so need to be consistent - As you know abstinence is only 100%

Advantages of COCP - ‘doesn’t require invasive methods like coil’ - 99% effective if taken properly

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Controls timing of period by taking it back to back so if you don’t want to come on for holiday you can control it Pill improves acne Reduced pms Reduced risk of ovarian uterine and colon cancer

Disadvanatges - Side effects like headache, breast tenderness and mood changes - Breakthrough bleeding – bleeding in first few months you take pill - Doesn’t protect against STI – still need barrier

Risks - VTE o o o o - cancer o

Small risk in developing clots in legs and lungs Small risk in getting stroke or heart attack Have you had any clots or stroke previously? Risk increased if you smoke or obese or immobile for long time Increase risk of breast and cervical cancer but risk stops after using

Contraindications - Patient cant take pill if they o Are pregnant o Smoker and over 35 o Over 35 and stopped smoking less than a year o Previous VTE or risk factors of it o FHx of breast cancer o Suffer from migraine with aura - Ask patient o Have you suffered from migraines with aura o Any family histyr of bresst cancer o Any family history of VTE or previous clots o Do you smoke o Are you pregnant Starting pill and missed pill - Starting o Start any time as long as you are not pregnant o You need to use condoms for first 7 days o When was your LMP - Missed o One pill – take missed pill straight away. Take rest of pack as normal. No emergency contraception o Two pill – take recent pill you have missed. Don’t take pill before this. Use condoms for 7 days

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If 7 or more pills left in pack then finish pack and have 7 day break Less than 7 then finish pack and start new pack. So back to back

Closing consultation - Summarise key points - Any questions - Check to see they understood ‘can you repeat …’ - Patient information leaflet - Take time to make a decision - Use condoms if not using at the moment - Thank patient If sick or diarrhoea - Sick within 2 hours – take another one - Severe diarrhoea for 24 hours – take pill like you missed pill Interactions - Epilepsy medication and st johns wort Withdrawal bleed - Not dangerous for back to back pill taking - Can get bleeding If they want to stop - Stop taking after finishing end of pack...