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Yr 2 Sem 1 Repro > 5.2 Introduction to Contraception > Flashcards

5.2 Introduction to Contraception Flashcards

1
Q

What is contraception?

A

Any method to prevent pregnancy

Blocking transport of sperm
Disruption of HPG axis
Inhibit implantation

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2
Q

What categories can methods of contraception be broadly split into?

A 
Natural 
Barrier 
Hormonal 
Prevention of implantation 
Sterilisation 
Emergency
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3
Q

Name three methods of natural contraception

A

Abstinence
Withdrawal method
Lactational amenorrhoea method

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4
Q

What are three fertility indicators?

A

Cervical secretions
Basal body temperature
Length of menstrual cycle

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5
Q

What is the principle behind the lactational amenorrhoea method?

A

Breastfeeding delays return of ovulation after childbirth

Suckling stimulus disrupts release of GnRH
Affects HPG axis

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6
Q

How long is the lactational amenorrhoea method reliable for and what does this rely on?

A

6 months after giving birth

Exclusive breast feeding

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7
Q

What types of barrier contraception?

A

Condoms

Diaphragm/Cap

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8
Q

What do low doses of progesterone do in contraception?

A

Thicken cervical mucus

Does not inhibit LH surge so ovulation still likely

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9
Q

How do contraceptives with high dose of progesterone work?

A

Inhibit positive feedback of oestrogen
No LH surge
No ovulation

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10
Q

What is the principle action of the COCP?

A

Prevents ovulation

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11
Q

What are secondary actions of the COCP?

A

Inhibit implantation

Thicken cervical mucus

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12
Q

Advantages of COCP

A

Relieve menstrual disorders

Reduced risk of ovarian and endometrial cancer

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13
Q

Disadvantages of COCP

A 
User dependent 
Interactions with medications 
Increased risk of breast and cervical cancer
Increased risk of MI/stroke 
No STI protection
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14
Q

What is the principle action of high dose progesterone contraceptives? (Injection and implant)

A

Prevents ovulation

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15
Q

What are the secondary actions of high dose progesterone contraceptives? (Injection and implant)

A

Thicken cervical mucus

Prevent endometrial proliferation.

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16
Q

Advantages of progesterone injection

A

Reliable

Useful for women who can’t have contraception with oestrogen

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17
Q

Disadvantages of progesterone injection

A

Appointment every 12 weeks
Osteoporosis in low weight patients
Delay in fertility returning
No STI protection

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18
Q

How long does the progesterone implant last for?

A

3 years

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19
Q

Advantages of progesterone implant

A

Reliable
LARC
Women who can’t have oestrogen in contraception
Fertility returns quickly

20
Q

Disadvantage of progesterone implant

A

Minor procedure
May have unpredictable periods
No STI protection

21
Q

How should the progesterone only pill be taken?

A

Every day, without a break

22
Q

What is the principal action of the progesterone only pill?

A

Thicken cervical mucus

23
Q

Which contraceptive pill does not stop ovulation and why?

A

Progesterone only pill

Because it is low dose progesterone so the LH surge is not inhibited

24
Q

What are the two types of coil?

A

Intrauterine system IUS - Progesterone releasing

Intrauterine device IUD - Copper

25
Q

How long does the IUS work for?

A

3-5 years

26
Q

What is the principal action of the IUS?

A

Prevents implantation

- Reduces endometrial proliferation

27
Q

What is the secondary action of the IUS?

A

Thickens cervical mucus

28
Q

What is the IUD?

A

Plastic device with added copper

29
Q

How long is the IUD effective for?

A

5-10 years

30
Q

What is the principal action of the IUD?

A

Copper is toxic to sperm and ovum

31
Q

What is the secondary action of the IUD?

A

Endometrial inflammatory reaction

  • Prevents implantation
  • Changes consistency of cervical mucus
32
Q

Advantages of the coil

A

Convenient

Long duration of action

33
Q

Disadvantages of the coil

A 
Unpleasant insertion
Risk of uterine perforation
Irregularity in menstruation
No protection from STI
Displacement
34
Q

Name for male and female sterilisation

A

Vasectomy

Tubal ligation/Clipping

35
Q

How does a vasectomy work?

A

Vas deferens cut or tied to prevent sperm from entering ejaculate

36
Q

How does tubal ligation work?

A

Fallopian tubes cut or blocked to stop ovum travelling from ovary to uterus

37
Q

Define subfertility

A

Failure of conception in a couple having regular, unprotected coitus for one year

38
Q

Difference between primary and secondary infertility

A

Primary - Never conceived

Secondary - Previously conceived including abortion and ectopic pregnancy

39
Q

Name the three groups of ovulatory disorders leading to subfertility

A

Hypothalamic-pituitary failure

Hypothalamic-pituitary-ovarian Dysfunction

Ovarian failure

40
Q

Broad groups of uterine/peritoneal disorders

A

Uterine fibroids
Endometriosis
Pelvic inflammatory disease

41
Q

Causes of tubal damage

A 
Endometriosis
Ectopic pregnancy
Pelvic surgery
Past pelvic infection
Mullerian developmental anomaly
42
Q

How can fertility be increased?

A

Stop smoking
Reduce alcohol levels
Reduce stress
Healthy diet

Women only- loose weight

43
Q

Who may be referred to a fertility clinic?

A

A woman of reproductive age who has not conceived after one year of unprotected vaginal intercourse, in absence of any known cause of infertility

44
Q

Who may be suitable for an early referral to a fertility clinic?

A

Women >36yrs
Known clinical cause for infertility
History of predisposing factors for infertility

45
Q

What are the three main types of treatment for infertility?

A

Medical treatment to restore fertility

Surgical treatment to restore fertility

ART

Yr 2 Sem 1 Repro (10 decks)

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