32) Contraception

Question 1

What is the Definition of “Contraception”?

Answer 1

• They’re products designed to PREVENT pregnancy

Question 2

What are the 2 Types of Contraceptive Methods?

Answer 2

1) NON-Hormonal

2) Hormonal

Question 3

What are the NON-HORMONAL C-Methods??

Answer 3

1) Behavioural - Include Lactational Amenorrhoea, Coitus Interruptus and Cervical Mucus Method

2) Intrauterine Devices (IUDs) - Copper IUD and Mierna Coil - Progestin

3) Barrier Method - Include Condoms, *Cervical Caps, Diaphgradm, Spermicide + Sponges

4) Surgical Sterilisation - Include Vasectomy of V-Deferens for Men, and Tubal Ligation

5) Abstinence - Coitus Interruptus, or Sexual Abstinence (completely avoiding sex to avoid pregnancy)

Question 4

What is Lactational Amenorrhea and Cervical Mucus Method?

Answer 4

Lactational Amenorrhea - Temporary

• Suckling STIMULATES Prolactin –> SUPPRESSING Gonadotropin-RH
• This REDUCES Ovulation - Effective Upto 6 MONTHS Post-Partum

Cervical Mucus Method

• BEFORE Ovulation - Mucus becomes thin, stringy + elastic
• Due to INCREASED Progesterone
• Used as an indicator to AVOID intercourse

Question 5

What are the Types of IUDs?

Answer 5

Copper Coil

• it induces aseptic inflammation on Endometrium

making it unsuitable for implantation

Mirena Coil - Progestin

• this thickens CERVICAL mucus, making it unsuitable for implantation

Question 6

What are the HORMONAL C-Methods??

Answer 6

1) Oral Contraceptive Pills - Combined Oral CPs or Progestine-Only Oral CPs

2) Injectable, or Subdermal Progestin

3) Contraceptive Patch

4) Vaginal Ring

Question 7

Explain the Oral Contraceptive Pills

Answer 7

1) Combined Oral CPs (COCP)

• Contains Oestrogen / Progestin
• PREVENT LH Surge –> INHIBITING Ovulation
• Make the Endometrium atrophic

2) Progestin-Only Oral CPs (POOC)

• ONLY Progestin
• SUITABLE for Breastfeeding Women
• It thickens CERVICAL mucus –> INHIBITS endometrial proliferation

Question 8

What is EMERGENCY CONTRACEPTION?

Answer 8

• LEVENORGESTREL 1.5mg Tablet - Given within 72h of UNPROTECTED Sex
• ULIPRISTAL

Question 9

What are the Adverse Drug Effects / Contraindications?

Answer 9

• Venous Thromboembolism
• Hypertension
• Hepatic Adenomas
• Oestrogen-Dependent Tumors

Question 10

What are the Indications?

Answer 10

• Prevent Pregnancy
• Control Symptoms in Abnormal Uterine Bleeding (AUB)
• PCOS
• Hyperandrogenism
• Endometriosis