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Adolescence > Contraception > Flashcards

Contraception Flashcards

1
Q

contraception saves lives through…

A

preventing unwanted or unsafe pregnancy and abortions

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2
Q

is contraception still a major challenge

A

yes

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3
Q

how does contraception empower women

A

give them the power to make their reproductive choices

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4
Q

how does contraception enhance economic development

A

women’s access to education and improved career opportunities

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5
Q

are fertility rates higher in developing or developed countries than in developing countries

A

developing countries

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6
Q

why are fertility rates higher in developing countries

A

access to contraception is more of a challenge

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7
Q

what effect can contraception have on developing countries

A

improve economic capabilities of country

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8
Q

main types of contraception

A
  • oral contraceptive pill
  • implants
  • injections
  • vaginal rings
  • intrauterine devices (IUDs)
  • barrier: external and internal condoms, diaphragms
  • surgical: tubal ligation, vasectomy
  • emergency contracpetion
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9
Q

what hormones can the OCP be

A
  • progesterone only
  • combined progesterone and oestrogen
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10
Q

which contraceptives are long acting reversible contraceptives (LARC)

A
  • implants
  • injections
  • vaginal rings
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11
Q

which contraceptives are progestin (synthetic progesterone) based

A
  • OCP
  • implants
  • injections
  • vaginal rings
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12
Q

what are some short-term contraception methods

A
  • OCP
  • diaphragm
  • condom
  • withdrawal (less reliable)
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13
Q

__% of Australian women will use contraception at some point in their lives

A

80%

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14
Q

most common form of contraception used (2) in Aus

A
  • OCP
  • male condoms
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15
Q

as women get older which form of contraception is decreased in use

A

hormonal contraception
(male condom use remains relatively stable)

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16
Q

what are 2 reasons why there might be a decline in hormonal contraception use as women get older

A
  • looking to start a family
  • undesirability of side effects
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17
Q

how many australian women experience an unintended pregnancy

A

1 in 4
(despite wide access to contraception in aus)

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18
Q

why are LARCs recommended

A
  • because has potential to increase effectiveness
  • because does not need to be remembered on daily basis to be effective
  • would reduce number and cost of unwanted pregnancies in australia
    (not changing options being used; using tech we already have)
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19
Q

availability of technologies for reversible female but not male contraception means women generally take greater responsibility by

A
  • carrying greater financial costs
  • incur associated health burdens (side effects, unplanned baby) (even when non-female contraception)
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20
Q

what 2 types of contraception supported by PBS

A

these are combined OCP ie/ COCs
forms supported that are made from (other progestin forms exist)
- levonorgestrel (progestin) + ethinylestradiol
- norethisterone (progestin) + ethinylestradiol

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21
Q

what are ethinylestradiol in combined OCPs for

A

oestrogen decreased when using OCP as it reduces ovary’s ability to produce oestrogen => oestrogen replaced in a small dose

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22
Q

is there a need for better access, use, acceptance, uptake of contraception to reduce undesirable outcomes (eg/ 11% of women aged19-24 report having an unintended pregnancy)

A

yes

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23
Q

very shortly how does the OCP work

A

changing natural hormone cycles

24
Q

what levels are similarly low both on the pill and when pregnant

A

gonadotrophin level (from pituitary)

25
Q

nromal cycle hormone : (high gonadoptrophins?)

A

rising oestrogen w falling FSH, followed by LH surge which causes rise in progesterone made by corpus luteum

26
Q

hormone cycle w progestin

A

progesterone levels stay high whilst on pill (if take sugar pill then progesterone goes low which when menstruation occurs)
but high progesterone causes low levels of gonadotrophin so cycle blocked => follicles don’t grow and mature and ovulate => oestrogen levels low and hence COCs

27
Q

progesterone and oestrogen and are what hormones but are not what unlike testosterone

A
  • sex hormones
  • they are not androgens
28
Q

steroid hormone signaling mechanism

A
  • progesterone able to readily cross cell membrane
  • progesterone crosses and interacts with progesterone receptor
  • acted on progesterone receptor moves into nucleus and bind to DNA (progesterone receptor = DNA-binding transcription factor)
  • binding to DNA activates gene expression
  • include genes that act in uterus for promoting implantation
29
Q

large number of steroid related transcripiton factors (receptors) & quite distinct from other steroid receptor families
which are closely and not closely related

A

progesterone receptor is very closely related to androgen receptor and glucocortiocoid receptor (stress response receptor)
progesterone receptor less related to oestrogen receptor

30
Q

when progesterone binds to its receptor it becomes

A
  • structure very related to structure of DNA so they bind in very specific locations
31
Q

DNA recognition sequence is important because

A

all the closely related receptors will bind the exact same sequence

32
Q

what is the significance of all the closely related receptors binding the exact same sequence

A
  • progesterone thought of as female hormone
  • testosterone thought of as male hormone
  • however both hormones are present in both female and males
  • progestin contraceptives are both like progesterone as well as testosterone
33
Q

are the progestins (synthetic progesterone) supported by PBS in australia of norethisterone and levonorgestrel more structurally closely related to testosterone or progesterone

A

testosterone

34
Q

what are the 3 categories for activity profiles of progestins

A
  • progesterone-like
  • androgen-like
  • anti-androgen
35
Q

what do anti-androgen progestins do

A

block testosterone action

36
Q

progestins are graded into how many generations & based on what

A

4 - based on how progesterone or androgen like they are

37
Q

3 possible side effects of progestin contraceptive agents

A
  • depression risk
  • breast cancer
  • cardiovascular risk
38
Q

which progestin is well associated with higher increased risk of both depression and breast cancer

A

levonogestrel

39
Q

the increased risk of side effects from progestin contraceptives aren’t as severe as….

A

what increased risk of unwanted pregnancy would be

40
Q

the increased risk of depression from progestin contraceptive use does associate with increased risk of _________ in users

A

suicide attempt

41
Q

risk of suicide attempt with duration of progestin contraceptive - has a pattern of what & in what demographic

A
  • increases most dramatically at earlier period of use, declines over longer periods of use (risk still remains increased)
  • emerges mostly in young people
42
Q

where else is progesterone receptor expressed (besides uterus) - list 2

A
  • brain
  • immune system
43
Q

emerging evidence shows what regarding progestin contraceptives and MRI scans

A
  • during periods of time on progestin contraceptive
  • there clear changes in brain structure that can be seen on MRI
44
Q

changes to brain structure from progestin contraceptives are more dramatic than the differences seen between brain of people of different sexes - T or F

A

true

45
Q

what could these changes in brain structure due to progestin contraceptives be linked to regarding side effects

A

depression risk

46
Q

in women on progestin contraception, immune system have changes in _____ populations that don’t occur in women not on

A

T cell population

47
Q

people using progestin contraception have changes to immune susceptibility as what occurs

A

a flattening in change of immune cells that normally occur across a cycle

48
Q

side effects and their risks for progestin contraceptives are variable based on

A

which contraceptive compound being used (progestin with oestradiol, and the dosage)

49
Q

list 3 other conditions progestin contraceptives also used for

A
  • acne
  • PCOS
  • endometriosis
50
Q

difference between contraception and sterilisation

A

reversibility

51
Q

by directly targeting ______ it prevents fertilisation without altering endocrine cycles

A

ovulation

52
Q

progesterone receptor blocker is used as an __________ _____

A

emergency contraception

53
Q

emergency contraception (progesterone receptor blocker) blocks ____

A

implantation

54
Q

what is progesterone receptor found to be critical for

A

release of oocyte from ovary (ovulation)

55
Q

research to look at non-hormonal contraception involving progesterone receptors by looking at

A

what genes are regulated by progesterone receptors in ovulation that could be blocked to prevent oocyte release

Adolescence (5 decks)

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