conntraception Flashcards
what are the different modes of action of contraception ?
prevention of ovulation
prevention of fertilization
prevention of implantation
thickening of cervical mucus
what is the lactational amenorrhea method of contraception ?
allow women to safely rely on breastfeeding as a family planning method and this can be used as long as the woman is:
fully breast feeding ( baby fully dependent )
no periods
less than 6 months postpartum
what is the “safe period” method based upon ?
based on the assumption that :
the ovum life span os 24 hours post ovulation
spermatozoa are capable of fertilization for 4 days
ovulation occurs 12-16 days before the onset of the next menses
- safe period is not safe
what are the barrier methods of contraception ?
condom
diaphragm
how is the diaphragm used ?
- before intercourse a spermicide gel is applied over the diaphragm and all around the ring , and is inserted in the vault
- should be left for 8 hours after intercourse
- diaphragm can be washed and reused
what chemical methods are available ?
spermicides
what is the active chemical in spermicides ?
nonoxynol-9 , used alone or usually with a barrier method
what important instruction must the female be aware of when using spermicides ?
no douching for 6 hours after intercourse
when should we avoid using spermicides ?
in young age
frequent intercourse
STDs
what are the hormonal methods of contraception?
combined OCPs
Hormone releasing vaginal rings
contraceptive patches
monthly combined injectables
what is the mode of action in combined hormonal contraception ?
- estrogen is given in certain doses and causes the inhibition of ovulation through suppression of the hypothalamo-pituitary-ovarian axis
- progesterone is given simultaneously to avoid the unopposed effect of oestrogen on the endometrium
how long are combined pills supposed to be taken ?
they are taken for 21 days then stopped for a week
when does withdrawal bleeding happen when using combined pills?
2-3 days after stoppage
when should the new course for OCPs be started ?
5th day of menstruation
what is the mode of action of OCPs ?
inhibition of ovulation
interference with fertilization
effect on the endometrium ( edema of the stroma and atrophy of the glands)
what is used to delay menstruation ?
progesterones more than OCPs
what are the side effects of OCPs?
thrombo-embolic disorders
slight transient liver impairment
decreased milk production
menstrual disturbances ( spotting , breakthrough bleeding, hypomenorrhea, amenorrhea)
when is post pill amenorrhea diagnosed ?
after 3 months after stoppage of pills and is related to prolonged suppression of the hypothalamus
how do you manage in a case of break through bleeding with a patient on OCP?
increase the dose of OCP on the 5th day of menstruation
inn what conditions are OCPs contraindicated ?
In CVD inn VTE breast cancers liver cancers migranes with auras immobilization breast feeding above 35 y/o and a smoker above 35 BMI SLE APS ( anti-phospholipid)
what is a vaginal contraceptive ring ?
ring that releases progesterone and oestrogen and has a similar effect to OCP but bypasses the first pass metabolism by the liver
how is a vaginal contraceptive ring used ?
to be left inn for 21 days and may be removed during intercourse
what is a contraceptive patch ?
same idea as vaginal rings, avoid the first pass metabolism by the liver
how is a contraceptive patch used ?
replaced every 3 weeks with a one week interval
