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Repro > 20 - Contraception > Flashcards

20 - Contraception Flashcards

1
Q

define the pearl index?

A

the number of contraceptive failures per 100 women-years of exposure

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2
Q

what statistical tool is used for providing contraceptive failure rate?

A

Life Table Analysis

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3
Q

what is LARC?

A

long-acting reversible contraception

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4
Q

what is a benefit of using LARC?

A

minimises user input and so minimises user failure rates

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5
Q

2 ways in which LARC may fail?

A

Method failure

user failure

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6
Q

what is the % of women who will get pregnant while using no contraception?

A

80%

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7
Q

if male condom is used correctly and every time, what % will result in pregnancy?

A

2%

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8
Q

which method of contraception (except sterilisation + vasectomy) is most effective against pregnancy?

A

Implant

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9
Q

when is the highest chance of getting pregnant?

A

sex on days 8 - 19

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10
Q

how long does the egg survive?

A

24 hours

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11
Q

how long does sperm survive?

A

95 % - less than 4 days

5% - up to 7 days

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12
Q

what are the 3 types of combined hormonal contraceptions?

A

pill

patch

vaginal ring

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13
Q

which hormones are used in the combined hormonal contraception?

A

EE (ethinyl estradiol)

synthetic progesterone

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14
Q

what regime must combined hormonal contraception follow?

A

Standard regime = 21 days with a hormone free week

BUT

Can have tailored regimes - e.g. without having withdrawal bleeds

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15
Q

describe the combined pill - when should it be taken?

A

taken daily - anytime in 24 hours

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16
Q

give 2 disadvantages of the combined pill?

A

have to remember taking it every day

not suitable for those with GI upset

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17
Q

what is the combined patch called?

A

patch EVRA

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18
Q

how often is the patch EVRA changed?

A

weekly

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19
Q

name a possible side effect of patch EVRA?

A

skin reactions

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20
Q

what is the combined ring called?

A

Nuvaring

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21
Q

how often is Nuvaring changed?

A

every 3 weeks

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22
Q

when can Nuvaring be taken out and when might people choose to do so?

A

can be taken out for 3 hours/ 24 hours - might want to remove for sex

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23
Q

give 4 symptom-related benefits to combined methods of contraception?

A

Regulate/reduce bleeding

Improve acne

Improve hirsutism

improve PMS (by stopping ovulation)

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24
Q

give 7 more serious conditions which combined methods often reduce?

A

functional ovarian cysts

ovarian cancer

endometrial cancer

benign breast disease

rheumatoid arthritis

colon cancer

osteoporosis

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25
Q

give 6 common side effects of combined methods?

A

Breast tenderness

Nausea

Headache

Irregular bleeding first 3 months

Mood

Weight gain

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26
Q

give 4 examples of serious risks associated with combined contraception?

A

DVT/ PE

cervical cancer

breast cancer

MI

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27
Q

when does the POP (progesterone-only pill) need to be taken?

A

Take at the same time every day without a pill-free interval

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28
Q

describe 3 contraindications for POP?

A

frequent GI upset

current breast cancer

past/ present liver tumours

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29
Q

what is the name of the POP an what is its window period?

A

Desogestrel pill – 12 hour window period

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30
Q

why are contraindications less frequent in POP than combined?

A

oestrogen-free

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31
Q

describe 5 progestogenic side effects?

A

Appetite increase

Hair loss/gain

Mood change

Headache

Acne

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32
Q

what hormone is injected in ‘the jag’?

A

progesterone

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33
Q

what is the dose indicated in the jag?

A

150 mg 1ml deep

34
Q

whereabouts is the jag given?

A

into the upper outer quadrant of the buttocks

35
Q

how often is the jag given?

A

every 13 weeks

36
Q

what type of injection is the jag?

A

intramuscular

37
Q

describe the 3 actions of the jag?

A

1 - prevents ovulation

2 - alters cervical mucus therefore hostile to sperm

3 - endometrium is unsuitable for implantation

38
Q

describe 3 advantages to the jag?

A

Only need to remember every 12-14 weeks

70% women amenorrhoeic after 3 doses

Oestrogen-free so few contraindications

39
Q

describe 3 disadvantages to the jag?

A

delay in return to fertility

weight gain

Reversible reduction in bone density (risk of osteoporosis)

40
Q

what is the ‘rod’ called?

A

Subdermal Progestogen implant Nexplanon

41
Q

how much progesterone does the rod contain?

A

68 mg

42
Q

describe the action of the progesterone implant?

A

inhibits ovulation

effects cervical mucus

43
Q

describe 3 advantages of the implant?

A

Can last 3 years (or be removed at any time)

No user input needed

No causal effect on weight

44
Q

describe 2 possible side effects of the implant?

A

prolonged/ frequent bleeding

mood changes

45
Q

what is the intrauterine device AKA?

A

the coil

46
Q

what type of contraception is intrauterine contraception?

A

LARC

47
Q

how long does the coil last?

A

5 - 10 years use

48
Q

describe 3 advantages for using the coil?

A

little user imput

fitted at any age/ parity

side effects stop as soon as it is removed

49
Q

name 3 (small) risks when fitting the coil?

A

infection

perforation

expulsion

50
Q

name 2 occasions in which the coil is not suitable?

A

untreated pelvic infection

distorted endometrial cavity

51
Q

name 3 actions of the copper IUD?

A

toxic to sperm

stops sperm reaching egg

prevents implantation of fertilised egg

52
Q

what hormones are present in copper IUD?

A

none

53
Q

a possible side effect of Copper IUD?

A

make periods heavier/crampier

54
Q

how long does copper IUD last?

A

5-10 years

55
Q

is copper IUD contraindication to MRI?

A

No

56
Q

action of levonogestrel IUS?

A

affects cervical mucus and endometrium

stops fertilisation of egg

57
Q

initial side effect of levonogestrel IUS which eases within 4 months?

A

irregular bleeding

58
Q

which contraception is also licensed to treat HMB and as the progestogenic part of HRT?

A

Mirena

59
Q

describe 3 methods of emergency contraception?

A

copper IUD

levonorgestrel pill (Levonelle)

Ulipristal pill (ellaone)

60
Q

which method of emergency contraception is most effective?

A

copper IUD

61
Q

when can copper IUD be used as emergency contraception?

A

within 120 hours of UPSI/

day 19 of 28 day cycle

62
Q

when does levonorgestrel pill need to be taken as emergency contraception?

A

within 72 hours

63
Q

when does ulipristal pill need to be taken as an emergency contraception?

A

within 120 hours

64
Q

which method of emergency contraception has contraindications?

A

ulipristal pill

65
Q

when should contraception be started to ensure immediate cover?

A

first 5 days of cycle

66
Q

when can a woman get pregnant after delivery?

A

21 days after delivery

67
Q

when can woman get pregnant after miscarriage/ abortion?

A

5 days after

68
Q

when is breast-feeding contraceptive and for how long?

A

only if feeding every 4 hours and amenorrhoeic - contraceptive for first 6 months

69
Q

which type of contraception are breast-feeding women advised to use?

A

any

70
Q

is female sterilisation reversible?

A

no

71
Q

what is a positive side affect of female sterilisation?

A

reduced risk of ovarian cancer

72
Q

how is vasectomy achieved?

A

Vas deferens divided and ends cauterised small incision midline scrotum

73
Q

does vasectomy affect testosterone/ sexual function?

A

no

74
Q

which act is there to offer protection around termination of pregnancy?

A

1967 UK Abortion Act

75
Q

how many doctors need to sign off an abortion to support a woman’s request?

A

2

76
Q

when can surgical TOP (STOP) be carried out?

A

5-12 weeks

77
Q

when can medical TOP (MTOP) be carried out?

A

5-24 weeks

78
Q

which 2 drugs are involved in MTOP?

A

mifepristone

misoprostol

79
Q

which drugs are involved in home MTOP?

A

misoprostol

80
Q

what is the major longterm effect of abortion?

A

emotional - depends on mother, reasons for abortion etc.

81
Q

give 5 examples of barrier methods of contraception?

A

diaphragm

cervical cap

male condom

female condom

spermicidal foam

Repro (28 decks)

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