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Charis & Ellie VS Reproduction > Contraception > Flashcards

Contraception Flashcards

1
Q

Who decided eligibility criteria for contraceptives in UK?

A

Determines whether particular method of contraception is suitable to prescribe

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2
Q

What is CHC?

A

Combined hormonal contraception

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3
Q

Examples of CHC?

A
  • COCP
  • Evra patch
  • Novaring
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4
Q

What is primary mechanism of CHC?

A

Ovulation suppression

So it causes endometrial changes and thinning

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5
Q

When do you start CHC?

A

First 5 days of period or anytime in cycle when reasonably sure not pregnant plus condom for 7 days

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6
Q

How to take COC?

A

Daily for 21 days followed by 7 day break

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7
Q

Risks of COC?

A

Venous thrombosis
Arterial thrombosis
Adverse effects on some cancers (breast, cervical)
Systemic HT

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8
Q

Arterial thrombosis RFs in COC?

A

Small increased risk of MI, particularly in smokers, potential increased risk of ischaemic stroke

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9
Q

What is someone has migraine with aura and is on the COC?

A

-Increases risk of ischaemic stroke

THIS IS CONTRAINDICATED

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10
Q

Side effects of COCP?

A

Nausea
Spots
Bleeding
Breast tenderness

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11
Q

WHat is IUD?

A

Intrauterine Device (copper coil)

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12
Q

Effect of IUD?

A

Direct toxic effect (same as spermicides)

Non hormonal

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13
Q

Can be used as emergency post-coital contraception?

A

Copper coil IUD

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14
Q

IUD effect on periods?

A

Longer, heavier, more painful, especially during first 3 months post insertion

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15
Q

Most suitable and reliable method for women after breast cancer?

A

IUD

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16
Q

How long does IUD last?

A

between 3-10 years depending on device

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17
Q

Effectiveness of IUD?

A

VERY effective

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18
Q

Insertion pain?

A

3/10 for mothers

5/10 for not mothers

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19
Q

Risk of IUD?

A

Perforation (small)

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20
Q

Who is IUD unsuitable for?

A

Women with submucosal fibroids

Uterine malformation

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21
Q

What is an IUS?

A

Plastic device placed in uterus which produces progesterone

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22
Q

What physiological effect does IUD have?

A

Endometrial changes/thinning

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23
Q

Physiological changes of IUS?

A

Thickened cervical mucous
Endometrial changes/thinning
Ovulation suppression

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24
Q

IUS lasts for?

A

3-10 years

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25
Q

Which is more effective IUD or IUS?

A

IUS

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26
Q

Four main IUS devices in market?

A

Mirena
Levosart
Kyleena
Jaydess

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27
Q

Mirena is licensed to treat?

A

Heavy periods
HRT
Other therapeutic uses (endometriosis)

28
Q

Kyleena has a how long license?

29
Q

Jaydees has how long a license?

30
Q

Average insertion of IUS pain?

A

3/10 for mums

5/10 for not mums

31
Q

IUS is unsuitable for?

A

Women with submucosal fibroids

Uterine malformation

32
Q

What is DMPA?

A

Depot medroxyprogesterone acetate

33
Q

Types of DMPA?

A

Depoprovera

SayanPress

34
Q

Physiology of DMPA?

A 
Ovulation suppression 
Thickened cervical mucous 
Endometrial changes/thinning 
Lower oestradiol 
Suppresses FSH
35
Q

Side effects of DMPA?

A 
Spots 
Weight gain
Nausea 
Headaches 
Bleeding 
Can decrease peak bone mass so not given to <21s
36
Q

What is LAM?

A

Lactational amenorrhoea method

37
Q

Phsysiology of LAM?

A

Ovulation suppression
Thicken cervical mucous
Endometrial changes/thinning

38
Q

Examples of POP?

A

Desogestrel

39
Q

POP is?

A

Progesterone only pill

40
Q

Physiology of POP?

A

Ovulation suppression
Endometrial changes/thinning
Thickened cervical mucous

41
Q

When to start POP?

A

Day 1-5 of period

42
Q

Contraindication of POP?

A

Current breast cancer

43
Q

Side effects of POP?

A

Nausea
Spots
Bleeding
Headaches

44
Q

What is an SDI?

A

Sub dermal implant

45
Q

Example of SDI?

A

Nexaplanon

46
Q

Physiology of nexplanon?

A

Ovulation suppression
Thickened cervical mucous
Endometrial thinning/changes

47
Q

What is most effective of all contraceptive methods?

48
Q

How long does SDI last for?

49
Q

SDI has a lot of hormonal side effects. True or False?

A

FALSE

-low and stable level of hormones

50
Q

Is the nexplanon safe for most women?

A

Yes- it is progesterone only

51
Q

Main side effects of nexplanon?

A

Prolonged PV bleeding

52
Q

If bleeding with SDI what is DDx?

A

Cervicitis/endometriosis due to STI
Pregnancy complication
Cervical polyp
Cervical cancer

53
Q

How is bleeding often controllled on SDI?

A

CHC (if not contraindicated)

54
Q

Contraindication for SDI?

A

Current breast cancer

55
Q

Mechanical barriers are?

A

Female and male condoms
Cervical caps
Diaphragms

56
Q

Complications of a vasectomy?

A

Failure
Pain
Infection
Bleeding/haematoma

57
Q

Emergency contraception?

A

Emergency IUD

Emergency hormonal contraception (Ulipristal acetate or levonorgestrel)

58
Q

Examples of hormonal contraception in emergency?

A

Levonorgestrel

Ulipristal acetate

59
Q

Main mechanism of most hormonal methods?

A

Prevention of ovulation

60
Q

What is prevention of ovulation not the mechanism in?

A

Hormone coil

Traditional POP

61
Q

How does prevention of ovulation work?

A

Suppressing FSH and LH (-ve feedback hypothalamus/pituitary)

62
Q

What contraception methods have the mechanism ‘prevention of fertilisation’?

A 
Condoms 
Diaphragms + spermicide 
Female and male sterilisation 
Intrauterine devices 
Hormonal methods
63
Q

What is mechanism of hormonal contraceptive methods?

A

Prevention of implantation

64
Q

Secondary mechanism of action for intrauterine devices?

A

Prevention of mechanism

65
Q

How does prevention of implantation work?

A

Created hostile endometrium or direct toxicity

66
Q

Non-contraceptive benefits of hormonal contraception?

A
  • Period pain
  • Heavy bleeding
  • Irregular PV bleeding
  • PMS
  • Cyclical breast tenderness
  • Ovarian cysts
  • Endometriosis
  • Ovarian cancer
  • Acne or hirsutism (CHC only)
  • Perimenopausal symptoms (CHC only)

Charis & Ellie VS Reproduction (71 decks)

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