Contraception Flashcards
1
Q
Key facts of women aged 16-49 taking contraception
A
- Combined oral contraceptive pill → 25%
- Progestogen-only pill → 5%
- Progestogen-only implant/ injectable → 3%
- Intrauterine methods (coil) → 6%
- Sterilisation → 28%
- Not using contraception despite sexual activity and not wishing to be pregnancy → 12%
2
Q
Effectiveness and efficacy of contraceptives
A
- Pearl index (no. contraceptive failures/ 100 women/ year)
- Life table index (cumulative contraceptive failure/ specified time)
3
Q
Key facts of combined contraceptive pill
A
- Orally administered pill combining ethinyl oestrodiol and synthetic progesterone
- Take for 21 days, 7 days off the pill, 3 months continuously, 7 days off the pill, repeat
4
Q
Mechanism of action of the combined contraceptive method
A
- Alters LH and FSH (lack of LH surge)
- Inadequete endometrium (prevents implantation)
- Increased viscosity of cervical mucous (prevent sperm penetration)
5
Q
Other benefits of taking CCP
A
- Regular and less painful heavy periods
- Reduced functional ovary
- 50% reduction in endometrial and ovarian cancer risk
- Improved acne
- Reduced risk of benign breast disease, rheumatoid arthritis, colon cancer, osteoporosis
6
Q
Risk of venous thromboembolus in CCP
A
- After major surgery
- Thrombophilia
- FH of VTE and under 40 years old
- BMI more than 40
- Underlying vascular disease
- Post-natal (under 21 days)
7
Q
Other risk of taking the CCP
A
- Small increased risk of ischaemic stroke
- Small increased risk of breast cancer
- Doubled risk of cervical cancer with 10 years of use
8
Q
Contraindication of CCP
A
- Migraines + aura
- Thrombophilia
- Breast cancer
- Major surgery
- Stroke
- Ischaemic heart disease
9
Q
Key facts of the contraceptive patch
A
- Small transdermal patch that release hormones into bloodstream preventing pregnancy -> EVRA
- Lasts 7 days, change weekly for 3 weeks, 1 week off patch
- Wearable in water
- Helps with heavy and painful menstruations
- Increased BP -> headaches
- Protects against ovarian, womb and bowel cancer
- Contraindication
- Smnokers
- Over 35
- Over 90kg
10
Q
Key facts of the vaginal ring
A
- Plastic ring inserted into the vagina that released continuous dose of oestrogen and progesterone
- Provides 1 month of continous uninterrupted protection
- Works depsite vomitting and diarrhoea
- Doestn work against STIs
- Use anytime in menstrual cycle
- 21 days of use, 7 days off, repeat
11
Q
Key facts of the progesterone only pill (POP)
A
- Lower failure rates in older women (lower fertility, less sexually active)
- 2 types
- 3 hour (must be taken within 3 hour window each day)
- 12 hour (must be taken in 12 hour window each day)
- Take once everyday continously
- Causes impenetrable cervical mucous
12
Q
Keys factors of the contraceptive injection
A
- Lasts 8 or 13 weeks (depends on type)
- Useful to those unable to take medication everyday
- Must be consistent with injection times
- Useful for those who cannot take oestrogen containing contraceptives
- Side effects
- Weigth gain
- Headaches
- Mood swins
- Breast tenderness
- Irregular bleeding
- Disadvantages
- Long wait for returning fertility
- Reduction in bone density (reversible)
13
Q
Key facts of intrauterine contraceptive
A
- Long-acting reversible contraceptive (LARC)
- Can be inserted anytime during menstrual cycle
- Must be removed by an specialist sexual health professional
- Heavy, long and painful periods in first 3-6 months
- Risk of pelvic infection
- No protection against STI’s
14
Q
Difference between IUS and IUD
A
- IUD releases copper into cervix (also thickens cervical mucous)
- IUD releases progesterone
15
Q
Female sterilisation
A
- Laparascopic tubal ligation
- 1/500 risk of failure
- Risk of tubal occlusion
