Contraception 💘 Flashcards
Examination
Medical history Drug history Family history Sexual history Check blood pressure and bmi Check ukmec
Fertility awareness method
Keeping track of menstrual cycle and only having sex when you’re not fertile
Advantages of fam
No hormones
no alteration to menstrual cycle
helps with conception in the future
user dependent
Disadvantages of fam
Less effective
No intercourse for 8-9 days per cycle requires motivation
no protection from STI‘s
Lactational amenorrhea method
Breast-feeding being used as contraception you need to have no periods fully breast-feeding and less than 6/122 postpartum
works because of the increased prolactin which suppresses the release of GnRH from the hypothalamus which interrupts FSH and LH
98% effective
Coitus interruptus
Withdrawal however pre ejaculate also contain sperm
is perfectly use it’s 96% affective typically used it’s 78% effective
Combined hormonal contraception
Inhibits ovulation by acting on the hypothalamus pituitary ovarian axis to reduce LH and FSH
secondary effects include alterations to cervical mucus and endometrium
Types of combined hornomnal
Pill
Patch (no patch week 4)
Vaginal ring (no ring week 4)
Advantages of combined hormonal
Regulates menstruation reduces heavy bleeding and pain decreased risk of endometrial and ovarian cancer and colorectal cancer
improved acne and may help with pre-menstrual symptoms
Disadvantages of combined hormonal
Doubled risk of thromboembolism increased risk of stroke and MI
small increased risk of breast cancer relies on user to take effectively
increased risk of cervical cancer
Progesterone only contraception
Increase volume and viscosity of cervical mucus preventing Sperm penetration (12hr window for new)
Advantages of progesterone only
Works quickly, easy to use, safe, 12 hour window, very safe, may help dysmenorrhea, no delay in return to fertility, can be used until the age of 55
Disadvantages of progesterone only
Hormonal side effects
Irregular bleeding
Injectable
Injected into the fatty tissue every 13 weeks, risk of pregnancy is 4 in 1000. Assessment of osteoporosis and cardiovascular risk is needed
Advantages of injectable
Reduced bleeding
reduced endometriosis pain
LARC
less visits to the clinic
Disadvantages of injection
Not possible to remove once given there’s a mean weight gain of 3 kg over two years, delay infertility return up to one year, small loss of bone mineral density, weak associations with breast cancer and cervical cancer
Implant
Rod inserted into arm
Lasts for 3 years
1in 1000 risk of pregnancy
Advantages of implant
Very safe, lasts three years, rapid return to fertility after removal, may help dysmenorrhea
Disadvantages of implant
Irregular bleeding patterns, relies on health professionals to fit and removed. Risks of fitting include infection expulsion non insertion and nerve damage which is rare
Ius
Coil fitted in reduced lining of uterus
Three types are mirena kyleena and jaydess
Advantages of ius
LARC, fit and forget, reduction of bleeding and pain, five or three yrs , immediate return to fertility
Disadvantages of ius
Risks with fitting such as infection, relies on health professionals to fit and remove
Copper iud
Toxic to ovum and sperm
Can cause heavier and longer periods
Diaphragm
Inserted with spermicide
Requires health professional to fit
Male sterilization
Vasectomy which is snipping of the vas deferens additional contraception until sterilization confirmed can lead to late failure chronic pain and one in 2000 fail
Female sterilization
Laparoscopy which is clipping of the fallopian tube‘s additional contraception for seven days. Risks include bowel perforation, bleeding, infection, ectopic pregnancy, post operation pain
1 in 200 fail
Hysterodcopic sterilization
Placing a coil in the Fallopian tubes which makes scar tissue blocking the eggs
1 in 500 fail
