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Semester 3 repro > Contraception > Flashcards

Contraception Flashcards

1
Q

What are the contraception methods that require ongoing action?

A 
→ Oral contraception
→ barrier methods
→ Fertility awareness
→ Coitus interruptus
→ Oral emergency contraception
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2
Q

What are the methods which prevent contraception by default?

A

→ IUD/IUI/IUS
→ Progestogen implants
→ progestogen injections
→ Sterilisation

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3
Q

What are the risks of treatment?

A 
→ Cardiovascular 
→ Neoplastic
→ emotional
→ infection
→ allergy
→ iatrogenic
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4
Q

What are the risks of no treatment ?

A

→ childbirth related
→ abortion related
→ Social and economic costs

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5
Q

What is the latest progestogen?

A

→ Drospirenone

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6
Q

What do estrogens act on?

A

→ Anterior pituitary and hypothalamus
→ directly on the ovary
→ on the endometrium

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7
Q

Where do progestogens act on?

A 
→ Anterior pituitary and hypothalamus 
→ Directly on the ovary 
→ On the endometrium
→ Fallopian tubes
→ cervical mucus
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8
Q

How does the combined oral contraceptive work?

A

→ Supraphysiological levels of progestogens and estrogens are given because this creates negative feedback
→ gnRH is not produced so FSH and LH are not produced
→ no follicle development and no ovulation

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9
Q

What happens if only estrogen is given?

A

→ Endometrium keeps proliferating

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10
Q

Why is progesterone added to the COCP?

A

→ Endometrium becomes thin
→ Implantation would not occur
→ Fimbriae become very inactive and delays gamete transport

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11
Q

What are the benefits of combined oral contraception?

A

→ reliable
→ Safe
→ Unrelated to coitus
→ rapidly reversible

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12
Q

What cancers does the COCP prevent?

A

→ 1/2 risk of ovarian cancer

→ 1/2 risk of endometrial cancer

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13
Q

What conditions does the COCP help?

A

→ endometriosis
→ Menorrhagia
→ dysmenorrhoea

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14
Q

What are the cardiovascular risks of the COCP?

A

→ Arterial - HBP, smoking

→ Venous - DVT, PE, migraine

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15
Q

What are the neoplastic risks of the COCP?

A

→ breast
→ cervix
→ liver

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16
Q

What are the 3 gastrointestinal risks of COCP?

A

→ COH/insulin metabolism
→ Weight gain
→ Crohns

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17
Q

What are the 3 hepatic risks of COCP?

A

→ Hormone metabolisms
→ Congenital nonhemolytic jaundice
→ Gallstones

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18
Q

What are the 3 dermatological risks of COCP?

A

→ Chloasma
→ Acne
→ erythema multiforme

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19
Q

What are the 3 psychological changes that COCP can have?

A

→ Mood swings
→ Depression
→ Libido

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20
Q

How do you take the COCP?

A

→1st packet the 1st day of period
→ 21 pills and stop for a 7 day break
→ restart each new packet on the 8th day
→ if missed pills then no pill free interval

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21
Q

What medications can interact with the COCP?

A

→ liver enzyme inducing drugs
→ Rifampicin and anti-epileptics
→ Broad spectrum antibiotics

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22
Q

What are the 2 progestogen only implants?

A

→ Nexplanon

→ Norplant

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23
Q

What is the progestogen only IUD called?

A

→ mirena

24
Q

Why is cerelle better than progesterone only pills?

A

→ As effective as the combined contraceptive
→ no estrogen - no effects on breastfeeding
→ bleeding is as predictable as the combined pill

25
Q

How do you use the combined vaginal contraceptive (ring)?

A

→ Vaginal delivery for 21 days

→ remove for 7 days

26
Q

How do copper containing IUDs work?

A

→ Destroying spermatozoa
→ Preventing implantation - inflammatory reaction
→ Sterile endometrium due to a foreign body in the uterus

27
Q

What are the 3 copper bearing IUDs called?

A

→ Ortho T380
→ Multiload 275
→ Multiload 250

28
Q

What are the 2 progesterone IUDs called?

A

→ Mirena

→ Jaydess

29
Q

What are benefits of IUCDs?

A 
→ Non user dependent
→ Immediately and retrospectively effective 
→ reversible 
→ longterm
→ reliable
→ unrelated to coitus
30
Q

What are disadvantages of the IUCDs?

A 
→ Fitted by trained medical personnel
→ Fitting can cause pain and discomfort 
→ periods can become heavier and more painful 
→ no protection against infection
→ threads can be felt
31
Q

What are the risks of IUDs?

A

→ Miscarriage if pregnancy occurs
→ Ectopic
→ expelled if not deep enough
→ Uterus can be perforated

32
Q

What are absolute contraindications of IUDs?

A

→ Pelvic inflammatory disease
→ Suspected pregnancy
→ Unexplained vaginal bleeding
→ Abnormalities of uterine cavity

33
Q

What are relative contradindications of IUDs?

A

→ not mutually monogamous
→ Nulliparity
→ Menorrhagia/dysmenorrhea
→ Small uterine fibroids

34
Q

What are advantages of the male condom?

A

→ Man in control
→ protects against STIs
→ no health risks

35
Q

What are disadvantages of the male condom?

A

→ Last minute use
→ needs to be taught
→ Can cause allergies

36
Q

What are advantages of the female condom?

A

→ Protects against STIs
→ Can be put in advance
→ not dependent on erection

37
Q

What are disadvantages of the female condom?

A

→ Messy
→ Expensive
→ obtrusive

38
Q

What must caps be used with?

A

→ Spermicide

39
Q

What are advantages of diaphragm caps?

A

→ Can be put in advance

→ protection against cervical dysplasias

40
Q

What are advantages of suction caps?

A

→ Suitable for women with poor pelvic muscles

→ unobtrusive

41
Q

What are disadvantages of diaphragm caps?

A

→ needs to be taught
→ messy
→ higher UTI
→ higher candidiasis

42
Q

What are disadvantages of suction caps?

A

→ Accessible and suitable cervix
→ not easy to find a teacher
→ higher failure rate than diaphragm

43
Q

How long can sperm and egg survive?

A

→ egg 24 hrs

→ sperm 5 days

44
Q

How long does the egg take to reach the uterus and implant?

A

→ 4 days

45
Q

What are the advantages of the fertility awareness method?

A

→ Non medical
→ can be used in 3rd world
→ allowed by catholics
→ closeness between partners

46
Q

What are disadvantages of the fertility method?

A

→ Failure rate is user dependent
→ requires skill
→ cooperation
→ limiting sexual activity

47
Q

What are the 3 post coital pills?

A

→ EllaOne
→ Levonelle
→ Schering PC4

48
Q

When can you take emergency contraception?

A

→ upto 72 hours after unprotected sex

49
Q

When can you put an IUD in as emergency contraception?

A

→ upto 5 days after unprotected sex

50
Q

What does Levonelle contain?

A

→ 750 mg of levonorgesterel

51
Q

What is PC4 contraindicated in?

A

→ focal migraine attack

52
Q

What is Levonelle contraindicated in?

A

→ Women taking potent liver enzyme medication

53
Q

What is EllaOne?

A

→ selective progestagen receptor

54
Q

What is the effectiveness of Levonelle upto 24hours?

A

→ 95%

55
Q

How do PC4 and levonelle prevent pregnancy?

A

→ Postpone ovulation in 1st part of cycle

56
Q

How do copper IUDs prevent pregnancy?

A

→ Copper kills sperm in 1st part of cycle

→ prevents implantation in 2nd part of cycle

57
Q

What are the efficacies of COCP, depo provera, IUCDs, IUS, implants and POP?

A

→ <1/100 woman will get pregnant

Semester 3 repro (12 decks)

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