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3rd Year - Reproductive Diseases > 2.1. Contraception - Powerpoint > Flashcards

2.1. Contraception - Powerpoint Flashcards

1
Q

What are the 3 methods in which Contraception works?

A
  1. Hormonal Methods
  2. Non-Hormonal Methods
  3. Permanent Methods
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2
Q

What are the different forms of Contraception?

A
  1. Combined Oral Contraception
  2. Progestogen-Only Methods
  3. Emergency Contraception
  4. Sterilisation
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3
Q

What are the different ways the Combined Oral Contraction can be administered?

A
  1. Pills
  2. Patch
  3. Vaginal Ring
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4
Q

What are the different ways the Progesterone Only Contraction can be administered?

A
  1. Pills
  2. Injection
  3. Implant
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5
Q

What are the Ideal Contraception Criteria?

A
  1. Reversible - All except Sterilisation
  2. Effective - None 100% (Best Vasectomy, then Implant)
  3. Convenient and Unrelated to Intercourse - Most Except Condoms
  4. Free of Adverse Side Effects - None (Oestrogen containing the most serious Side-Effects)
  5. Protective against STI’s - None
  6. Non-Contraceptive Benefits - Particularly COC
  7. Low Maintenance - Implant / Coi
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6
Q

What impacts on the Effectiveness of Contraception?

A
  1. Method Failure - True Failure
  2. User Failure - Missed Pills
  3. Breastfeeding
  4. Frequency of Intercourse
  5. Age - Background Fertility
    Note - Most Methods are 99% effective if used consistently and correctly
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7
Q

What is the Effectiveness of the Combined Oral Contraceptive Pill?

A

> 99%

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8
Q

What is the Combined Oral Contraceptive Pill a combination of?

A

2 hormones:

  1. Ethinyl Oestradiol (EE)
  2. Synthetic Progesterone (Progestogen)
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9
Q

What is the normal dose of the Combined Oral Contraceptive Pill?

A
  1. 20 - 35 micrograms of Ethinyl Oestradiol (EE)
    Plus
  2. a) “Second Generation” - Levonorgestrel (LNG) and Norethisterone (NET)
  3. b) “Third Generation” - Gestodene (GSD) and Desogestrel (DSG)
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10
Q

How often is the Combined Oral Contraceptive Pill taken?

A

21 days straight, followed by 7 days pill free:
1. Start Day 1 but up to 5 without Barrier Contraception
2. Takes 7 days to “Switch off” Ovaries
3. Start any time if not Pregnant, but condoms for 1 week
Note - Can use for 3 months continuously without a “Pill free Week”

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11
Q

What is the Mode of Action of the Combined Oral Contraceptive medication?

A
  1. It prevents Ovulation by altering the Follicular Stimulating Hormone, and the Luteinizing Hormone
  2. It prevents implantation by providing an Inadequate Endometrium
  3. It inhibits Sperm Penetration of the Cervical Mucus by altering the Quality / Character of the Mucus
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12
Q

What are the Non-Contraceptive Benefits of the Combined Oral Contraceptive Medication?

A
  1. Regular Bleed with a Potential Reduction in Painful, Heavy, Menstruation and Anaemia
  2. Reduction in Functional Ovarian Cysts
  3. 50% Reduction in Ovarian / Endometrial Cancer
  4. Improvement in Acne
  5. Reduction in Benign Breast Disease / Rheumatoid Arthritis / Colon Cancer / Osteoporosis
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13
Q

What are the Risks associated with the Combined Oral Contraceptive Medication use?

A
  1. Risk of Venous Thromboembolism (15-25 per 100,000)
  2. Very Small Risk of Ischaemic Stroke
  3. Very Small Risk of Breast Cancer
  4. Cervical Cancer
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14
Q

What is the name of the Progestogen-Only Pill?

A
  1. Desogestrel Pill

2. Cerazette (New) - likely to be more effective

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15
Q

How often is the Progestogen-Only Pill taken?

A

12 Hour Window Period - Pills taken within 3 hours of the same time every day, without a Pill Free Interval
Note - Maximum effect is 48 hours after ingestion

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16
Q

What is the Mode of Action of the Progestogen-Only Pill?

A
  1. Cervical Mucus is rendered impenetrable by Sperm

2. Ovulation Effects

17
Q

What is the name of the Progestogen-Only Injection?

A

It is an Aqueous Solution of Crystals of the Progestogen Depomedroxyprogesterone Acetate (DepoProvera)

18
Q

In relation to the Depomedroxyprogesterone Acetate (DepoProvera) Injection:

  1. How much is given?
  2. How often is it injected?
  3. Where is it injected?
A
  1. 150mg
  2. Every 12 weeks
  3. Intramuscular Injection into the Upper Outer Quadrant of the Buttock
19
Q

What is the mode of action of the Depomedroxyprogesterone Acetate (DepoProvera) Injection?

A
  1. It prevents Ovulation
  2. It alters the Cervical Mucus, making it hostile to Sperm
  3. It prevents implantation by rendering the Endometrium unsuitable
20
Q

What are the Advantages / Disadvantages of Depomedroxyprogesterone Acetate (DepoProvera)?

A

Advantages:

  1. Good for Forgetful Pill Takers
  2. 70% women are Amenorrhoeic
  3. Oestrogen-Free

Disadvantages:

  1. Delay in return (but no reduction in) to Fertility
  2. Reversible Reduction in Bone Density
  3. Problematic Bleeding
  4. Weight Gain
21
Q

What forms the Subdermal Progestogen-Only Implant?

A
  1. Core - Etonogestrel (Progestogen)

2. The Rod is then covered in a Rate Controling Membrane made from Ethinyl Vinyl Acetate

22
Q

What is the Mode of Action of the Subdermal Progestogen-Only Implant?

A
  1. Inhibition of Ovulation (100% of Women, 3+ years, Regardless of Weight)
  2. Inhibiting Sperm entry into the Upper Reproductive Tract by effecting the Cervical Mucus
23
Q

What is the method of Female Sterilisation?

A
  1. ESSURE under Local Anaesthetic - Discontinued in the UK

2. Tube Ligation - Filshie Clips

24
Q

What is the method of Male Sterilisation?

A

Vasectomy - Permanent Division of the Vas Deferens under Local Anaesthetic

25
Q

What are the Disadvantages of a Vasectomy?

A
  1. Pain - due to Sperm Granuloma, a mass of Degenerating Spermatozoa surrounded by Macrophages
  2. Irreversibility - Anti-sperm antibodies are implicated in the Low Success Rates of Vasectomy Reversals
26
Q

What are the 2 main abortion methods?

A
  1. Medical (>80% in Grampian are Medical)
  2. Surgical
    Note - After 20 weeks referral to England
27
Q

What are the Indications for an Induced Abortion?

A
  1. Medical Reasons (Foetal Anomaly, Maternal Health)
  2. Social Reasons - Pregnancy has not past its 24th week, and continuation would cause greater harm to the health of the woman than if the pregnancy was terminated
28
Q

What would needed to be covered in a Clinical Consultation, with regards to an abortion?

A
  1. Methods of Termination
  2. Prolonged bleeding after the Termination of Pregnancy
  3. Counselling available after the Termination of Pregnancy
  4. Contraception Agree & Advise
  5. Bloods for Infections (STI’s)
  6. Certificate A Signed
29
Q

What is used in the Medical Termination of Pregnancy?

A

Mifepristone

30
Q

How does Mifepristone, used in the Medical Termination of Pregnancy, work?

A

It switches off the Pregnancy Hormone which is keeping the Uterus from Contracting, and allowing the Pregnancy to grow

3rd Year - Reproductive Diseases (41 decks)

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