Contraception Flashcards
What is a contraceptive?
Something that blocks the conception of a fetus; keeps egg and sperm apart
What is a contragestational agent?
Something that works to keep a fertilized egg (zygote) from implanting
What is an abortifacient?
Something that causes the termination of an established pregnancy
What is a vasectomy?
Cutting of the vas deferens
What is tubal ligation?
Cutting of the uterine tubes
What does a morning after pill do?
Keeps a fertilized egg from implanting
Fertilized eggs are less likely to implant with OCs (makes a hostile endometrium)
How does an IUD work?
Makes the uterus (endometrium) hostile for a fertilized zygote
Does this by releasing progesterone & making the endometrium thin
Physical signs of ovulation (x4)
- Drop in body temperature
- Production of thin, clear + watery cervical mucus
- Mittelschmerz: one-sided, cyclical abdominal pain associated with ovulation)
- Position of the cervix (elevated, softer + wetter cervix = more fertile)
Fertile vs infertile mucus
Fertile mucus has lots of K+ and Na+ (crystallizes on a plate)
Infertile mucus looks like goo
What is a combination pill? What does it do?
Combination of estrogen + progestin to create a pseudopregnancy
These hormones inhibit the release of GnRH
Low FSH –> little follicle development
No LH surge –> no ovulation
Creates: thick cervical mucus (inhibits sperm movement) & thin endometrium
Contraceptive patch (Evra)
Works the same as combination pills except its transdermal
Allows for the drugs to enter the system slowly
Doesn’t allow for uncompliance really
Contraceptive (Nuva) ring
Form of combined steroid contraceptive
Delivers estrogen + progesterone
Characteristics of progestin-only contraception
Formulated to avoid the side effects of estrogen (vomiting, nausea, tender breasts, deep vein thrombosis)
Do not reliably suppress ovulation –> thick, scanty mucus
Endometrium stays in a “pregnant” state –> doesn’t allow for zygote implantation
The mini pill
Progestin only
Missing a dose of this pill by hours –> leads to ovulation + pregnancy
Higher risk of contraceptive failure than combination pill
Progestin injections
Leaks out in high amounts
Progestin injections
Leaks out in high amounts
Risks with progestin-only injections
Dysfunctional uterine bleedings (DUB)
Weight gain
Decrease in libido (due to less estrogen)
Physiology of progestin-only injections (x4)
- Stimulation of endometrial growth by estrogen
- Inhibitory effect of progestins on endometrium (stimulate secretion by glands)
- Stimulates estradiol conversion to estrone (less potent)
- Decreases estrogen production by inhibiting pituitary-hypothalamo-gonadal axis
Long-acting reversible contraceptives (LARCs)
Contraceptive implants & IUDs
Very reliable, no problems with compliance & easy return to fertility
Progestin implants
Amount of progestin released decreases steadily after placement
Not available in Canada
Risks with progestin implants
Subdermal insertion is key (implant can migrate + cause damage)
Insertion & removal requires training
Depressed mood –> suicidal
Plan B (high dose progestin)
Inhibits natural progesterone and estrogen production and ovulation
Administered ASAP
Selective progesterone receptor modulator (SPRM)
Blocking of the progesterone receptors –> inhibits ovulation for days
Mifepristone
Antagonizes the effects of progesterone –> active myometrium
Causes endometrium to fall off
Misoprostol (PG) is given to increase uterine contractions as well
