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SGUL - Physiology 2 > Contraception > Flashcards

Contraception Flashcards

1
Q

What are some methods of contraception that require ongoing action by the individual?

A
  • Oral contraception
  • Barrier methods
  • Fertility awareness
  • Coitus interrupts
  • Oral emergency contraception
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2
Q

What are some methods that prevent contraception by default?

A
  • IUCD/IUI/IUS
  • Progestogen Implants
  • Progestogen Injections
  • Sterilisation
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3
Q

What is seen as the perfect contraception method?

A
  • 100% Reliable
  • 100% Safe
  • Non user dependent
  • Unrelated to coitus
  • Visible to the women
  • No ongoing medicinal input
  • Completely reversible in 24 hrs
  • No discomfort
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4
Q

What are some risks of treatment for contraception?

A
  • Cardiovascular problems: Arterial, Venous
  • Neoplastic: Breast Cancer, Liver
  • Emotional
  • Injection related
  • Allergic
  • Iatrogenic
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5
Q

What are the risks of no treatment for contraception?

A
  • Childbirth related
  • Abortion related
  • Social costs
  • Economic costs
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6
Q

What are the benefits of treatment for contraception?

A
  • Non contraceptive
  • Psychosexual
  • Choice
  • Sexual Health
  • Cost saving
  • Female equality
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7
Q

What are the benefits of no treatment for contraception?

A
  • Non interference
  • Population growth
  • Control of women
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8
Q

What are some combined oral contraceptions?

A
  • Oestrogen: EthinylOestradiol 20,30,35,50 micrograms

Progestogen
- Older 2nd gen: Norethisterone & Levonorgestal
- Newer 3rd gen: Desogestral, Gestodene & Norgestimate
- Latest: Drospirenone

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9
Q

Where do Oestrogen act?

A
  • Act on the Anterior pituitary & Hypothalamus glands
  • Directly on the ovary
  • On the endometrium
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10
Q

Where does Progestogen act?

A
  • Act on the Anterior pituitary & Hypothalamus glands
  • Directly on the Ovary
  • On the endometrium
  • On the fallopian tubes
  • On cervical mucus
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11
Q

What are the benefits of using combined oral contraception?

A
  • Reliable
  • Safe
  • Unrelated to coitus
  • Women in control
  • Rapidly reversible
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12
Q

What are the benefits of using non contraceptive oral contraception???

A
  • Halve ca ovary
  • Halve ca endometrium
  • Helps endometriosis, menorrhagia, dysmenorrhea
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13
Q

State the Pill rules about taking combined oral contraception

A
  • Start 1st packet 1st day of a menstrual period
  • Take 21 pills and stop for 7 day break (PFI)
  • Restart each new packet on 8th day (same)
  • Do not start new packets late
  • If late or missed pills in first 7 days, then use condoms
  • If missed pills in last 7 days no PFI
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14
Q

What are some interacting medications for combined oral contraception?

A
  1. Liver enzyme inducing drugs
    - Affect metabolising of both oestrogen and Progestogen
    - Beware rifampicin and anti-epileptics
  2. Broad spectrum antibiotics
    - Affect enterohepatic circulation of oestrogen only 40%
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15
Q

What is combined vaginal contraceptive?

A
  • Same as COCP except vaginal delivery (ring) for 21 days
  • Remove for 7 days
  • Advantage is that you don’t have to take everyday
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16
Q

What are the Progestogen only methods for contraception?

A
  1. Default methods
    - Implants: Nexplanon, Norplant
    - Hormone releasing IUCD: Mirena IUS
  2. User dependent methods
    - Norethisterone, Ethynodiol diacetate
  3. Injectables
    - Depo Provera, Noristerat
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17
Q

Why is cerelle better than older POPs?

A
  • As effective as COCP
  • No oestrogen: CIs e.g. breastfeeding
  • Favourable side effect profile vs older POPs
  • Bleeding as predictable as COCP
  • 12 hour window
18
Q

What are IUCDs?

A

Copper bearing intrauterine contraceptive devices are inserted into the uterus by suitably trained practitioners and May be left in situ long term and act by:
- Destroying spermatozoa
- Preventing implantation: inflammatory reaction and prostaglandin secretion as well as a mechanical effect

19
Q

What are the different types of IUCD’s?

A
  1. Copper bearing
    - Ortho T 380 – 8 -12yr
    - Multiload 375 – 5yr
    - Multiload 250 – 5y
    - Nova T 380 – 5yr
    - Nova T 200 – 5yr
    - GyneFix (IUI) – 5y
  2. Hormone bearing
20
Q

What are some benefits of using IUCDs?

A
  • Non user dependent
  • Immediately and retrospectively effective
  • Immediately reversible
  • Can be used long term
  • Extremely reliable
  • Unrelated to coitus
  • Free from serious medical dangers
21
Q

What are some disadvantages of using IUCDs?

A
  • Has to be fitted by trained medical personnel
  • Fitting may cause pain or discomfort
  • Periods may become heavier & painful
  • It does not offer protection against infection
  • Threads may be felt by the male
22
Q

List some risks of using IUCD’s as contraception?

A
  • Miscarriage if left in situ if a pregnancy
  • ?ectopics
  • May be expelled
  • The uterus may be perforated
23
Q

List some contraindications when deciding to use IUCDs

A
  • Current pelvic inflammatory disease
  • Suspected or known pregnancy
  • Unexplained vaginal bleeding
  • Abnormalities of the uterine cavity
24
Q

List some relative contraindications when deciding to use IUCDs

A
  • Nulliparity
  • Past history of pelvic inflammatory disease
  • Not in mutually monogamous relationship
  • Menorrhagia / Dysmenorrhoea
  • Small uterine fibroids
25
Q

List the advantages of using condoms in males

A
  • Man in control
  • Protects against STIs
  • No serious health risks
  • Easily available (free at Family Planning clinics)
26
Q

List the disadvantages of using condoms in males

A
  • Last minute use
  • Needs to be taught
  • May cause allergies
  • May cause psycho sexual difficulties
  • Higher failure rate among some couples
  • Oily preparations rot rubber
27
Q

List the advantages of using condoms in females

A
  • Woman in control
  • Protects against STIs
  • Can be put in advance and left inside after erection lost
  • Not dependent on male erection to work
28
Q

List the disadvantages of using condoms in females

A
  • Obtrusive
  • Expensive
  • Messy
  • Rustles during sex
  • Uncertain failure rate
29
Q

What are the different types of caps used in contraception?

A
  • Diaphragm Caps
  • Suction (cervical) caps
30
Q

Describe the use of diaphragm caps in contraception

A
  • Made of latex
  • Fit across vagina
  • Sizes 55 – 95mm in 5mm jumps
  • Must be used with spermicide and left in at least 6 hours after sexual intercourse
31
Q

Describe the use of Suction (Cervical) caps in contraception

A
  • Made of plastic
  • Suction to cervix or vaginal vault
  • Different sizes
  • Must be used with spermicide and left in 6 hours or more
32
Q

What are the advantages of using diaphragm caps as contraception?

A
  • Woman in Control
  • Can be put in advance
  • Offers protection against cervical dysplasias
  • Perceived as “natural”
33
Q

What are the disadvantages of using diaphragm caps as contraception?

A
  • Diaphragm Caps
  • Needs to be taught
  • Messy
  • Higher failure rate than most other methods
  • Higher UTI
  • Higher Candiasis
34
Q

What are the advantages of using suction caps as contraception?

A
  • Suitable for women with poor pelvic muscles
  • No problems with rubber allergies
  • Very unobtrusive
  • Woman in control
35
Q

What are the disadvantages of using suction caps as contraception?

A
  • Needs an accessible and suitable cervix
  • Higher failure rate than diaphragm
  • Not easy to find experienced teacher
36
Q

What are some fertility awareness signs you have to be vary about?

A
  • Prediction of ovulation ? 14/7 before period
  • Sperm can survive 5 days in female tract
  • Ova can survive 24 hours
  • Ova are fertilised in the fallopian tube and take 4 days to reach the uterus and implant
  • Cervical mucus is receptive to sperm around the time of ovulation
  • Use Periodic Abstinence/alternative contraception to avoid pregnancy
  • Time intercourse to pre-ovulatory phase to conceive
37
Q

List some factors you take into consideration for natural family planning

A
  • Temperature
  • Rhythm
  • Cervix position
  • Cervical mucus
  • Persona
  • Lactational amenorrhoea (LAM)
38
Q

List the advantages about fertility awareness

A
  • Non medical
  • Can be used in 3rd world
  • Allowed by Catholic church
  • Can result in closeness of understanding between partners
39
Q

List the disadvantages about fertility awareness

A
  • Failure rate heavily user dependent
  • Requires skilled teaching
  • May require cooperation between partners
  • May involve limiting sexual activity
  • Can cause strain
40
Q

What are some emergency forms of contraceptions?

A
  • Postcoital pills: prevents Up to 72 hours after unprotected sexual intercourse (UPSI)
  • Schering PC4: prevents 3 out of 4 pregnancies which would have occurred
  • Copper bearing IUCDs: Prevents Up to 5 days after presumed ovulation or 5 days after one single episode of UPSI at any time of the cycle, Failure extremely rare
  • Levonelle: prevents 7 out of 8 pregnancies
  • ellaOne (ulipristal): Similar to levonelle
41
Q

Describe the postcoital pills: Levonelle

A
  • Levonelle 2 consists of 2 tablets each containing 750 micrograms of Levonorgestrel
  • 1.5mg one dose

SGUL - Physiology 2 (37 decks)

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