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4 RED > 8 Contraception and HRT > Flashcards

8 Contraception and HRT Flashcards

1
Q

What percentage of pregnancies are unplanned?

A

30%

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2
Q

Name 4 methods of contraception with no user failure

A

IUD
IUS
Implant
Sterilisation

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3
Q

Name 3 methods of contraception with user failure

A

barrier
hormonal
natural family planning

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4
Q

Name 3 main categories of contraception

A

methods with no user failure
methods with user failure
emergency contraception

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5
Q

What is the only type of contraception to also offer STI and HIV protection?

A

condoms (barrier)

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6
Q

What should be avoided when using male condoms?

A

oil-based lubricants
lipstick
nails

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7
Q

What is the female condom usually made of?

A

soft thin polyurethane

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8
Q

What is the failure rate for perfect and typical use of the male condom?

A

p 2%

t 17%

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9
Q

What is the failure rate for perfect and typical used of the female condom?

A

p 5%

t 21%

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10
Q

What are diaphragm and caps made out od?

A

latex or silicon

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11
Q

Are diaphragms/caps reusable?

A

yes

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12
Q

What might be used wiht a diaphragm/cap?

A

spermicide

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13
Q

How long before sex can a dipahragm/cap be inserted?

A

3 hours

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14
Q

For how long does a diaphragm/cap need to be left in after sex?

A

6 hours

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15
Q

What is the failure rate for perfect and typical use of diaphragm and caps?

A

p 4-8%

t 12-29%

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16
Q

What accounts for the difference in failure rates for perfect and typical use of diaphragms and caps?

A

comfortability wearing it

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17
Q

What problem is associated with using a spermicide with diaphragms/caps?

A

may increase HIV transmission

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18
Q

What is LARC?

A

long-acting reversible contraception

methods requiring administration <1 per month

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19
Q

What are the benefits of LARC?

A 
independent of user memory
effective
longer lasting
convenient
cost effective
fully reversible
no long term impact on fertility
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20
Q

Name 4 types of LARC

A

IUS (hormonal)
IUD (non-hormonal)
Implant - progestogen only
Injection - progestogen only

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21
Q

Name 3 types of progestogen only injections

A

Depo-provera
Savana PRess
Noristerat (although short term only)

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22
Q

What is the MOA of IUS?

A

release of progestogen levonorgestrel

thins endometrium
thickens cervical mucous
inhibits ovulation

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23
Q

Name 4 types of IUS

A

Mirena
Levosert
Kyleena
Jaydess

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24
Q

How long do IUS usually last?

Name one exception

A

5 years

Jaydess (3 years)

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25
Q

How effective are IUS?

A

> 99%

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26
Q

What are the 2 key non contraceptive benefits of IUS

A

reduces menstrual bleeding / dysmenorrhoea

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27
Q

Name one potential side effect of IUS

A

irregular bleeding

benign ovarian cysts

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28
Q

Name 5 contraindications for IUS use

A 
pregnancy
>48hr or <4week post-partum
unexplained vaginal bleeding
gestational trophoblastic disease
cervical cancer
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29
Q

What does an IUD have on it?

A

copper

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30
Q

What is the MOA of IUD?

A

foreign body reaction int he uterus (prevents implantation)

copper is toxic to sperm and ova

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31
Q

How long might an IUD work?

A

5-10 years

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32
Q

How effective is IUD?

A

99%

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33
Q

What are the 3 key advantages to IUD?

A

effective immediately
might be used as emergency contraception
non hormonal

34
Q

Name 2 key disadvantages of IUD

A

increased menstrual loss

inhibited dysmenorrhoea

35
Q

Which of IUS and IUD is beneficial for menstrual cycles?

A

IUS

36
Q

What is the brand name of implants?

A

Nexplanon

37
Q

What does Nexplanon contain?

A

Etonogestrel

38
Q

How long does Nexplanon last?

A

3 years

39
Q

What is the MOA of Nexplanon?

A

inhibition of ovulation

thickened cervical mucous

40
Q

What are the key benefits fo Nexplanon?

A

independent of intercourse
reduces HMBa dn dysmenorrhoea
immediate return of fertility when removed

41
Q

Name 3 key side effects of using nexplanon

A

irregular menstrual bleeding
hormonal side effects
affected by enzyme inducers

42
Q

What is the MOA of injectables?

A

inhibits ovulation
thickens cervical mucus
thins endometrium

43
Q

What is the failure rate for perfect and typical use of injectables?
why?

A

p >99%
t 96%
late injections

44
Q

Name one odd benefit to injectables

A

reduces severity of sickle cell crises if SCD

45
Q

Name off negative to injectables

A

decreases bone density - returns after stopping

46
Q

What are the 3 methods of administering combined hormonal contraception?

A

pill
patch
vaginal ring

47
Q

What might affect the effectiveness of combined hormonal contraception?

A

enzyme inducers

diarrhoea / vomiting (pill)

48
Q

Name 7 areas of contraindications for combined hormonal contraceptives

A 
breastfeeding
pospartum
smoking
HTN
obesity
history of bariatric surgery
headaches
49
Q

Which 2 hormones does the combined pill contain?

A

estrogen

progestogen

50
Q

What is the brand name for the combined patch?

A

Evra

51
Q

How long do you wear a combined patch for?

A

1 patch 1 week or 3 weeks

52
Q

What might reduce the efficacy of the combined patch?

A

> 90kg

53
Q

How are partially and fully detached combined patches managed?

A

the same

54
Q

What is the brand name for the combined vaginal ring?

A

Nuvaring

55
Q

How long do you leave a Nuvaring in for?

A

7 days

56
Q

Name the main sort of synthetic progestogen used in POP

A

Desogestrel

57
Q

When is POP taken?

A

same time everyday

58
Q

Name a key benefit to using POP

A

can be used in breastfeeding and many who can’t use CHC

59
Q

How many POP doses does it take to be effective?

A

2

60
Q

Name 4 contraindications for POP use

A

pregnancy
current breast caner
decompensated liver disease
some malignant liver tumours

61
Q

What are the 2 sorts of natural family planning?

A

fertility awareness methods

lactational menorrhoea

62
Q

What are the main fertility indicators?

A

basal body temperature
cervical secretions
length of menstrual cycle

63
Q

What criteria must be filled to use lactational amenorrhoea as a contraceptive?

A

baby <6m old
women amenorrhoeic
regular breast feeding >4 hrly in day
exclusively breastfeeding

64
Q

For how long after a vasectomy do you need to still use other contraception?

A

8-12 weeks

wait until semen tests are cleared

65
Q

What might be used for female sterilisation?

A

tubal occlusion
Filshire clipds
Salpingectomy

66
Q

How long might it take for female sterilisation to work?

A

1 - 3 months

67
Q

What are the 2 categories of emergency contraceptino?

A

Copper IUD

Hromonal

68
Q

What are the types of hormonal emergency contraception?

A 
Levonorgestrel
Ulipristal Acetate (ellaOne)
69
Q

What is UPSI?

A

unprotected sexual intercourse

70
Q

When does a copper IUD have to be inserted to work as an emergency contraceptive?

A

within 120 hours of first UPSI

71
Q

Who might be given a double dose of Levonorgestrel as emergency contraceptive?

A

BMI >25

72
Q

How long after UPSI do you have to use ellaOne as emergency contraception?

A

5 days

73
Q

What is the MOA of ellaOne?

A

synthetic progesterone receptor modulator

delays ovulatoin

74
Q

What is the definition of menopause?

A

cessation of menses for 12m+ if >45yrs

cessation of menses for 24m if age <45yrs

75
Q

What is premature ovarian insufficiency?

A

menopause <40yrs

76
Q

Name 4 long term effects of oestrogen deficiency

A

increased cardiovascular risk
increased total cholesterol and LDL cholesterol
Reduction in bone mineral density
Decreased glucose tolerance and insulin sensitivity

77
Q

What are the types of HRT?

A

combined (cyclical, or continuous)

estrogen only

78
Q

What HRT is offered to a woman with a uterus?

A

combined estrogen + progestogen

79
Q

What HRT is offered to a woman without a uterus?

A

oestrogen-only preparation

80
Q

What are the 4 routes for HRT?

A

transdermal
oral
IUS
low dose vaginal oestrogen

4 RED (15 decks)

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