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Reproductive > 7. Contraception > Flashcards

7. Contraception Flashcards

1
Q

What are the categories of contraception?

A 
Natural
Barrier
Hormonal control
Prevention of implantation
Sterilisation
Emergency contraception
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2
Q

What is lactational amenorrhoea?

A

Breastfeeding after childbirth to avoid pregnancy
Delays return of ovulation by disrupting gonadotropin release
Can be send effective for up to 6 months postnatally provided exclusive breastfeeding, complete amenorrhoea

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3
Q

What are the different barrier methods?

A

Male/female condoms
Diaphragms/cervical caps
Spermicides

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4
Q

What are the types of hormonal control?

A

Combined oestrogen and progestogen - COCP, patch, ring
Progestogen-only pill (POP)
LARC - progestogen depot and implant

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5
Q

What is the role of progesterone?

A

High levels enhances negative feedback of oestrogen, therefore pre-ovulation - reduces FSH and LH secretion, inhibits positive feedback - no LH surge, no ovulation
Lower levels do not inhibit LH surge, can still ovulate, will thicken cervical mucus

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6
Q

What is the main action of COCP?

A

Prevent ovulation

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7
Q

What is the secondary action of COCP?

A

Reduces endometrial receptivity to implantation, thicken cervical mucus

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8
Q

What are the advantages of COCP?

A

Reliable up to 99%
Can relieve menstrual disorders
Lowers risk of ovarian and endometrial cancer
Decrease acne severity in some

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9
Q

What are the disadvantages of COCP?

A

User dependant
No STI protection
Medication interaction
Contraindications - raised BMI, migraine, breast cancer
Side effects - menstrual irregularities, breast tenderness, mood disturbances
Increased risk of CV disease, stroke, VTE, breast cancer, cervical cancer

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10
Q

What is the main action of POP?

A

Thicken cervical mucus

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11
Q

What is the other action of POP?

A

Reduced cilia activity in Fallopian tube

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12
Q

What are the advantages of POP?

A

Reliable up to 99%

Can be used if COCP contraindicated

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13
Q

What are the disadvantages of POP?

A

No STI protection
Strict timing
Menstrual irregularities
Increased risk of ectopic pregnancy

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14
Q

What are the main actions of progestogen injection?

A

Inhibit ovulation, thicken cervical mucus, thin endometrial lining
Given IM every 12 weeks

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15
Q

What are the advantages of progestogen injection?

A

Reliable
No known medication interactions
Can be used if oestrogen contraindicated and raised BMI

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16
Q

What are the disadvantages of progestogen injection?

A

No STI protection
Not rapidly reversible
Menstrual irregularities

17
Q

What is the progestogen implant?

A

Small subcutaneous tube inserted in arm

High dose progestogen

18
Q

What are the main actions of progestogen implant?

A

Inhibit ovulation, thicken cervical mucus, thin endometrial lining

19
Q

What are the advantages of progestogen implant?

A

Reliable
Lasts for up to 3 years
Can be used if oestrogen contraindicated and raised BMI
Fertility returns faster than injection

20
Q

What are the disadvantages of progestogen implant?

A

No STI protection
Menstrual irregularities
Complications with insertion and removal

21
Q

What is the intrauterine system?

A

Progestogen releasing coil
Prevents implantation and reduces endometrial proliferation, thickens cervical mucus
Ovulation usually continues

22
Q

What is the intrauterine device?

A

Copper-containing coil

23
Q

What is the main action of IUD?

A

Copper toxic to ovum and sperm, preventing fertilisation

24
Q

What are the secondary actions of IUD?

A

Cervical mucus changes, endometrial inflammatory reactions inhibit implantation

25
Q

What are the advantages to the coil?

A

Convenient
Effective up to 99%
LARC from 3 to 10 years
IUS or treatment of menorrhagia

26
Q

What are the disadvantages of the coil?

A

No STI protection
Complications with insertion
Menstrual irregularities
Displacement/expulsion may occur

27
Q

What are the 3 types of emergency contraception?

A

Levonorgestrel - morning after pill, high dose progestogen, inhibits ovulation
Ulipristal acetate - selective progesterone receptor modulator, inhibits/delays ovulation
Copper IUD

Reproductive (22 decks)

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