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Y3 Reproduction > Contraception > Flashcards

Contraception Flashcards

1
Q

what are the three main mechanisms of action of contraception?

A

prevention of ovulation
prevention of fertilisation
prevention of implantation

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2
Q

how do contraceptives prevent ovulation?

A

hormonal methods work by suppressing FSH and LH

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3
Q

what is the main mechanism of moth hormonal methods of contraception?

A

prevention of ovulation

except hormone coil and traditional POPs

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4
Q

what is the mechanism of action of emergency hormonal contraception?

A

temporarily delays ovulation

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5
Q

how do some contraceptives prevent fertilisation?

A

creating a barrier

direct toxicity

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6
Q

name some contraceptives that work by preventing fertilisation

A 
condoms 
diaphragm + spermicide 
sterilisation 
IUDs 
hormonal methods
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7
Q

name some contraceptives that prevent implantation

A

hormonal methods
IUDs - second mechanism of action
copper coil as emergency contraception

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8
Q

how do some contraceptives prevent implantation?

A

create a hostile endometrium or cause direct toxicity

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9
Q

what is a traditional POP?

A

progesterone only pill that contains levonorgestrel or norethisterone

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10
Q

what is an IUD?

A

intrauterine device

aka the copper coil

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11
Q

what is an IUS?

A

intrauterine system

aka hormone coil

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12
Q

what is DMPA?

A

medroxyprogesterone acetate

aka depo provera

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13
Q

what is LAM?

A

lactational amenorrhoea method

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14
Q

what is SDI?

A

the subdermal implant

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15
Q

what types of contraception fall under the classification of LARC?

A

IUD
implant
DMPA injections

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16
Q

what does LARC stand for?

A

long acting reversible contraceptives

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17
Q

how long does the copper IUD last?

A

up to 10 years

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18
Q

what is the mechanism of action of hormone and copper coils?

A

mainly prevent fertilisation

also prevent implantation

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19
Q

what are there small risks of with hormone and copper coils?

A

perforation
PID
malposition/expulsion

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20
Q

when are hormone and copper coils unsuitable?

A

submucosal fibroids

uterine malformation

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21
Q

when can the copper IUD be kept in til if inserted over the age of 40?

A

til the menopause

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22
Q

is the copper IUD a hormonal method?

A

no

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23
Q

when can the copper IUD be used as emergency contraception?

A

up to 5 days after sex
OR
5 days after the earliest estimated day of ovulation

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24
Q

what is a common side effect of the copper IUD?

A

heavier, longer and more painful periods

especially in the first three months

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25
Q

what can help with the side effects of the copper IUD?

A

NSAIDs

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26
Q

what is the main suitable and reliable method of contraception for women who have had breast cancer?

A

copper IUD

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27
Q

which is more effective - IUD or IUS?

A

IUS

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28
Q

what is the main IUS in use?

A

mirena coil

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29
Q

besides contraception, what else can the mirena IUS be used for?

A

treat heavy periods
part of JRT
endometriosis
many other therapeutic uses

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30
Q

what are common side effects of IUS insertion?

A

irregular spotting
PV bleeding

in the first few months

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31
Q

what is the most effective of all contraceptive methods?

A

subdermal implant (SDI)

32
Q

what is another name for SDI?

33
Q

how long does the SDI last?

A

three years

34
Q

what hormone is released by the SDI?

A

progestogen only

35
Q

what is the main side effect of the SDI?

A

prolonged PV bleeding

36
Q

what is CHC?

A

combined hormonal contraception

37
Q

what is included under CHC?

A

combined pill
patch
ring

38
Q

what is the mechanism of action of CHC?

A

stops ovulation

39
Q

what is the COC?

A

combined oral contraceptive

40
Q

when should the COC be started?

A

first 5 days of period

OR

at any time in the cycle, should also use condoms for 7 days

41
Q

how is the COC taken usually?

A

daily for 21 days followed by a 7 day break

42
Q

what are possible off licence ways to take the COC?

A

tricycling - three packs then a 7 day break

continuous use

43
Q

what advice is given if patients take the COC continuously?

A

if you bleed for four days or more, stop for four days then start again

44
Q

what factors may affect the effectiveness of CHC?

A

impaired absorption
increased metabolism
forgetting to take it

45
Q

what are three possible risks of CHC?

A

venous thrombosis
arterial thrombosis
adverse effects on some cancers

46
Q

what should be done to minimise risk of VTE in patients using CHC?

A

prescribe the most effective option with the lowest risk

discuss signs and symptoms with the patient

47
Q

what possible circulatory effect can the COC have?

A

systemic hypertension

small increase in BP in some patients

48
Q

when should patients on the COC get their BP checked?

A

initially at three months

then annually

49
Q

what contraceptive is contraindicated in individuals with migraine with aura?

50
Q

what cancers can CHC have unwanted effects on?

A

breast cancer

cervical cancer

51
Q

what examination should be done before first prescription of CHC?

A

record BP and BMI

check smear status if relevant

52
Q

what should be referred to if a patient with multiple risk factors wants to start contraception?

53
Q

what cancers can CHC provide protection against?

A

ovarian cancer

endometrial cancer

54
Q

what are some common side effects of CHC?

A

nausea
spots
bleeding
breast tenderness

55
Q

what is the POP?

A

progestogen only pill

56
Q

name a POP commonly used

57
Q

what is the mode of action of desogestrel POP?

A

inhibits ovulation

58
Q

what are the three progestogen only methods of contraception?

A

POP
subdermal implant
DMPA

59
Q

how should progestogen only methods be started?

A

day 1-5 of period

OR

anytime if sure not pregnant + condoms for 7 days (2 for POP_)

60
Q

what is the main contraindication to progestogen only methods?

A

current breast cancer

61
Q

what are possible side effects of the POP?

A

nausea
spots
bleeding
headaches

62
Q

what are the two options for DMPA injections?

A

depo provera

sayana press

63
Q

what is the mechanism of action of DMPA injections?

A

lower estradiol

supresses FSH

64
Q

how are DMPA injections administered?

A

sayana press = self administered

depo by doctor

65
Q

what are possible side effects of DMPA injections?

A 
nausea 
weight gain 
spots 
headaches 
bleeding
66
Q

what is the most effective mechanism of emergency contraception?

A

copper IUD

67
Q

what should be offered first line as emergency contraception?

A

copper IUD

68
Q

what are the three possible options for emergency contraception?

A

copper IUD
EllaOne
levonelle

69
Q

what does EllaOne contain and how does this work?

A

ulapristal acetate

progestogen receptor modulator

70
Q

when can EllaOne be used?

A

up to 5 days after sex

71
Q

how does EllaOne work?

A

stops the LH surge and delays ovulation

72
Q

what makes EllaOne more effective?

A

taking it earlier

73
Q

what is levonelle?

A

essentially a big dose of progestogen

74
Q

when can levonelle be used?

A

best up to 72 hours after sex

can be used later if needed

75
Q

how does levonelle work?

A

inhibits ovulation

76
Q

when does a double dose of levonelle need to be taken?

A

body weight > 70kg

Y3 Reproduction (49 decks)

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