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Repro > 7. Contraception 2 (lecture) > Flashcards

7. Contraception 2 (lecture) Flashcards

1
Q

how do you inhibit sperm transport?

A

by thickening cervical mucus

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2
Q

which pill inhibits sperm transport by thickening cervical mucus?

A

progesterone only pill (POP)

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3
Q

what is the POP?

A

lower dose progesterone

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4
Q

what is POP a secondary action of?

A

COCP
progesterone depot
progesterone implant
intrauterine system

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5
Q

at lower doses, what does progesterone act to do?

A

progesterone doesn’t inhibit LH surge - ovulation still likely
but lower dose of progesterone will THICKEN cervical mucus - inhibiting sperm transport
(oestrogen still positive effect on hypothalamus and ant pit)

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6
Q

what is the principal action of progesterone only pill?

A

thickens cervical mucus, making it impenetrable to sperm

ovulation usually NOT prevented

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7
Q

what are the advantages of POP?

A

can be used where the COCP is contraindicated (cannot be used)

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8
Q

what are disadvantages of POP?

A

menstrual problems are common

must be taken at the same time each day (error for forgotten pills is only 3 hours late)

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9
Q

how should POP be taken?

A

pill containing progesterone only (lower dose)

taken everyday

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10
Q

explain how lower progesterone dose works? (POP)

A

lower dose, progesterone does NOT inhibit LH surge, ovulation still likely
lower dose only THICKENS cervical mucus, preventing sperm from penetrating

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11
Q

what are the 2 different coils used in inhibition of implantation?

A 
intrauterine system (IUS)
intrauterine device (IUD)
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12
Q

what does intrauterine system (IUS) contain?

A

progesterone

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13
Q

what does intrauterine device (IUD) contain?

A

copper

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14
Q

how do coils sit?

A

placed into the uterus

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15
Q

what is the principal action of IUS (system)?

A

progesterone reduces endometrial proliferation and prevents implantation
(high conc of progesterone, inhibits positive feedback of oestrogen)

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16
Q

what are secondary actions of IUS?

A

thickens cervical mucus

ovulation usually NOT prevented

17
Q

what are advantages of IUS?

A

convenient
long duration of action
can also relieve menstrual disorders

18
Q

what are disadvantages of IUS?

A

insertion may be unpleasant
IUS displacement / expulsion may occur
menstrual irregularity common in first 6 months
risk of uterine perforation (2/1000)

19
Q

what is an IUS?

A

small device made of plastic with added slow-release progestogen, that is placed into uterus

20
Q

how long does an IUS last?

A

can last between 3-5 years

21
Q

what is the principal action of intrauterine device (IUD)?

A

contains copper

copper is toxic to sperm and ovum - prevents fertilisation

22
Q

what are the secondary actions of IUD?

A

copper cause endometrial inflammatory reaction - prevents implantation
reduces penetration by sperm due to effect of copper on cervical mucus

23
Q

what are the advantages of IUD?

A

convenient
long duration of action
can also be used as emergency contraception (up to 5 days after unprotected intercourse)

24
Q

what are disadvantages of IUD?

A

insertion may be unpleasant
IUD displacement / expulsion may occur
periods may be heavier, longer, more painful
risk of uterine perforation (2/1000)

25
Q

what is uterine perforation?

A

injury to surrounding blood vessels or viscera such as the bladder or intestine

26
Q

what is an IUD?

A

small device made of plastic with added copper that is placed into the uterus

27
Q

how long can IUD be effective for?

A

5-10 years

28
Q

what is male sterilisation?

A

vasectomy

29
Q

what is the mechanism of action of male vasectomy?

A

vas deferens interrupted to prevent sperm entering ejaculate

sperm produce in seminiferous tubules –> rete testes –> vas deferens

30
Q

how is vasectomy performed?

A

under local anaesthetic

31
Q

how do you confirm whether a vasectomy was successful?

A

post-operative semen analysis to confirm no sperm in ejaculate (approx. 12-16 weeks after surgery)

32
Q

what are the advantages of sterilisation?

A

permanent

no hormonal side effects

33
Q

what is sterilisation in females?

A

tubal ligation / clipping

34
Q

what is the mechanism of action of tubal ligation / clipping?

A

fallopian tubes cut / blocked to stop the ovum travelling from the ovary to the uterus

35
Q

how is tubal ligation / clipping carried out?

A

under local / general anaesthetic

36
Q

what are the disadvantages of sterilisation?

A

should not be chosen if any doubt about having children in future

37
Q

what is the failure rate of vasectomy in males?

A

1/2000

38
Q

what is the failure rate of tubal ligation / clipping in females?

A

2-5/1000

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