Contraception Flashcards

1
Q

Describe the rhythm method of contraception

A

One commonly practiced method of contraception is to avoid intercourse near the time of ovulation. The difficulty with this method of contraception is predicting the exact time of ovulation.

It is usually stated that avoidance of intercourse for 4 days before the calculated day of ovulation and 3 days afterward prevents conception. However, such a method of contraception can be used only when the periodicity of the menstrual cycle is regular.

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2
Q

What is the failure rate of rhythm method of contraception?

A

The failure rate of this method of contraception, resulting in an unintentional pregnancy, may be as high as 20 to 25 percent per year.

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3
Q

Describe hormonal suppression of fertility - “The Pill”

A

It has long been known that administration of either estrogen or progesterone, if given in appropriate quantities during the first half of the monthly cycle, can inhibit ovulation. The reason for this is that appropriate administration of either of these hormones can prevent the preovulatory surge of LH secretion by the pituitary gland, which is essential in causing ovulation.

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4
Q

Why does administration of estrogen or progesterone prevent the preovulatory surge of LH secretion?

A

It has been suggested that immediately before the surge occurs, a sudden depression of estrogen secretion by the ovarian follicles probably occurs, which might be the necessary signal that causes the subsequent feedback effect on the anterior pituitary that leads to the LH surge.

The administration of sex hormones (estrogens or progesterone) could prevent the initial ovarian hormonal depression that might be the initiating signal for ovulation.

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5
Q

What is the failure rate of hormonal supression of fertility using various forms of “The Pill”?

A

The failure rate, resulting in an unintentional pregnancy is about 8 to 9 percent per year.

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6
Q

How many women are infertile?

A

About 5 to 10 percent of women are infertile

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7
Q

What is the general reason for infertility of females?

A

Occasionally, no abnormality can be discovered in the female genital organs, in which case it must be assumed that the infertility is due to either abnormal physiological function of the genital system or abnormal genetic development of the ova themselves.

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8
Q

What is the most commen cause of female sterility?

A

The most commn cause of female sterility is failture to ovulate. This failure can result from hyposecretion of gonadotropic hormones, in which case the intensity of hormonal stimuli is simply insufficient to cause ovulation, or it can result from abnormal ovaries that do not allow ovulation.

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9
Q

Describe the difference between hormonal systemic and non-systemic contraception

A

!!!

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10
Q

Name the four types of contraception

A
  • Behavioral (natural)
  • Hormonal
  • Barrier
  • Permanent sterilization
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11
Q

What is behavioral contraception?

A

Behavioral contraception also called natural family planning is when you abstrain from sex or use barrier methods during the calculated fertile time.

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12
Q

What is hormonal contraception?

A

Hormonal contraception contain estrogen and progesterone, or progesterone only. They prevent pregnancy by blocking the release of eggs from the ovaries (ovulation), thinning the lining of the uterus, or thickening the mucus in the cervix to help keep sperm from reaching the egg.

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13
Q

How can hormonal contraceptives be administered?

A

Hormonal contraceptives may be administeret orally, injected under the skin, placed on the skin as a patch, or placed in the vagina or uterus.

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14
Q

What is the mini-pill?

A

The mini-pill is a hormonal contraception that contains progestin but no estrogen.

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15
Q

How does the mini-pill work?

A

Mini-pill primarily work by thickening the cervical mucus, effectively preventing sperm from entering the uterus.

To work effectively, they must be taken at a certain time every 24 hours. Missing even one pill can greatly reduce effectiveness.

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16
Q

Describe the combination oral contraceptives (COCs)

A

The combination oral contraceptives contain a combination of estrogen and progestin, and work by preventing ovulation, thinning the endometrium and thickens the cervical mucus to prevent sperm from gentting into the uterus.

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17
Q

How are the hormone levels different from normal to usage of combination oral contraceptives?

A
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18
Q

Combination oral contraceptives can be divided into two types of pills - what is the difference in hormone levels between the two of them?

A
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19
Q

Combination oral contraceptives can be divided into two types of pills - what is the difference?

A

Monophasic pills provide the same level of hormones throughout the pill cycle

Triphasic pills induce a steady state of hormones, but at 3 different levels during the cycle

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20
Q

What is important to remember when taking birth control pills?

A

When taking the birth control pills, it is important to remember:
- Once a day at the same time everyday
- Use condoms for first moth
- Use condoms when on antibiotics
- Use condoms for 1 week if you miss a pill or take one late
- The pill offers no protection from STDs

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21
Q

Why does some take the progestin-only contraceptives instead of combination oral contraceptives?

A

Progestin-only contraceptives is commonly used by nursing mothers, because estrogen reduces milk production, and women with pre-existing risk of blood clots also use these because combination oral contraceptives gives a slight increase in the risk of blood clots.

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22
Q

What is injection contraceptive and how often is it administered?

A

Depo Provera (DP) is a contraceptive injection that contains progestogen, and the birth control injection (intramuscular) is given once every three months to prevent pregnancy

23
Q

How does injection contraceptives work?

A

The injection works by stopping ovulation, stopping menstrual cycles and thickens the cervical mucus, effectively preventing sperm from entering the uterus.

24
Q

What are the side effects of injection contraception?

A

Not every woman has side effects, but the common is listed below:
- Extremely irregular menstrual bleeding and spotting for 3-6 months
- No period after 3-6 months
- Weight change
- Breast tenderness
- Mood change
- Reduction in bone density

25
Q

What is a vaginal ring?

A

A vaginal ring (NuvaRing) is a ring inserted into the vagina that releases a low dose of a progestin and an estrogen over 3 weeks.

26
Q

What are the benefits of the vaginal ring?

A

The vaginal ring is 95-99% effective and does not require administrating pills daily. At the same time the ability to become pregnant returns quickly when use is stopped.

27
Q

What is “the patch”?

A

“The patch” is a contraceptive patch that is applied to the skin and gradually releases synthetic estrogen and progestin hormones to prevent pregnancy.

28
Q

What is a contraceptive implant?

A

Contraceptive implants is made up of two small rods (size of a matchstick), that is put under the skin in the inside of the upper arm. They slowly release progestogen, and works for 3-5 years depending on thek ind of implant.
- They can be taken out at any time

29
Q

What is emergency contraception?

A

Emergency contraception pills include levonorgestrel or ulipristal acetate, and they reduce the chance of a pregnancy by 75% if taken within 72 hours of unprotected sex.

30
Q

What are the mechanism of levonorgestrel?

A

Levonorgestrel works by preventing or delaying ovulation and impairing luteal function. It may also increase the thickness of the cervical mucus or affect sperm migration and function in the genital tract, thereby preventing fertilization of an egg.

31
Q

What are the mechanism of ulipristral acetate?

A

Ulipristal acetate inhibit or delay ovulation for 24-48 hours even on the day of the luteinizing hormone peak. Additionally it reduces the endometrial thickness, delay endometrial maturation and alterations in the progesterone-dependent markers required for implantation.

32
Q

What is the Yuzpe method?

A

The Yuzpe method uses estrogen combined with levonorgestrel

33
Q

What are the general mechanism of emergency contraceptive pills?

A
  1. Alters endometrium: Prevens the endometrium from preparing to receive an egg, so even if an egg has already been released, it can’t embed itself in the lining.
  2. Influences cervical fluid: Thickens cervical mucus to prevent sperm from reaching the uterus.
  3. Stops ovulation: Prevens the release of an egg from the ovaries by making the body think it’s already occured.
34
Q

Why should you only use emergency contraceptive pills in an emergency?

A
  • It causes nausea, mood swings, heart-burn and vomitting
  • It can disrupt the menstrual cycle
  • Repeated use can lead to difficulties in conception later
  • It doesnøt protect against STDs
  • Hormonal imbalances will cause disruptions in the menstrual cycle
35
Q

Name some barrier methods as contraceptives

A
  1. Spermicides
  2. Male condom
  3. Female condom
  4. Diaphragm
  5. Cervical cap
36
Q

What is the mechanism of barrier methods as contraceptives?

A

The barrier method prevents pregnancy by blocking the egg and the sperm from meetgin.

37
Q

How do spermicides work?

A

Spermicides chemically kills sperm in the vagina and can be utilized in different forms:
- Jelly
- Foam
- Suppository

It is only 76% effective when used alone, but it should be used in combination with another methos such as condoms

38
Q

What are the most common and effective barrier method when used properly?

A

Male condoms

39
Q

How do male condoms work?

A

Condoms prevents sperm from getting into the vagina with a typical effectiveness rate of 88%, but with spermicides its effectiveness levels raise up to 99%.

40
Q

Can you prevent sexually transmitted infections?

A

Latex in condoms prevents sexually transmitted infections

41
Q

What is a female condom?

A

A female condom works just like the male condom, but are inserted in the vagina and thereby blocks sperm from entering cervix

42
Q

What is a diapgrahm?

A

Diaphragm is a latex barrier placed inside the vagina during intercourse. It is inserted up to 18 hours before intercourse and can be left in for a total of 24 hours. Spermicide is also inserted in order to kill th sperm.

43
Q

What is a cervical cap?

A

A cervical cap is a latex barrier inserted in the vagina before intercourse. It must be filled with spermicidal jelly prior to use, and can be left in the body for up to a total of 48 hours.

44
Q

What is intrauterine devices?

A

Intrauterine devices are T-shped objects placed in the uterus to prevent pregnancy. It must be inserted during period and a natual childburd is required to use intrauterine devices. They are extremely effective without using hormones > 97%.

45
Q

Name two types of intrauterine devices

A

Copper T and Progestasert

46
Q

How does Copper T work?

A

Copper as an intrauterine device acts as spermicide and blocks the egg from implanting.
- It can prevent pregnancy for up to 10 years after insertion
- 99,2% effective

47
Q

How does progestasert work?

A

Progestasert releases hormones over a one year time frame and thereby thickens mucus and blocking egg from implanting.
- 98% effective

48
Q

How does progestasert work?

A

Progestasert releases hormones over a one year time frame and thereby thickens mucus and blocking egg from implanting.
- 98% effective

49
Q

What is sterilization?

A

Sterilization is a surgical method to permanently make a man or a woman unable to get kids

50
Q

What is the surgical method of sterilization of a female called?

A

Tubectomy

51
Q

What is the surgical method of sterilization of a man called?

A

Vasectomy

52
Q

Describe the tubectomy

A

Tubectomy is sterilization in the female by ligation of the tubae uterinae

53
Q

Describe the vasectomy

A

Vasectomy is sterilization in the male by ligation of vas deferens

54
Q

List up the contraceptives from most effective to least effective

A