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ESA 4 - Reproductive System > Contraception > Flashcards

Contraception Flashcards

1
Q

What is the role of oestrogen in the menstrual cycle in the early/middle follicular phase, before ovulation?

A

It has a negative effect on the anterior pituitary and hypothalamus, thus producing negative feedback

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2
Q

What else has a negative effect on the anterior pituitary during the early/middle follicular phase?

A

Inhibin

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3
Q

What is the role of oestrogen at ovulation?

A

It has a positive effect on the hypothalamus and anterior pituitary, causing the LH surge

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4
Q

What dose is progesterone at in the early/middle follicular phase (before ovulation)?

A

Moderate/high doses

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5
Q

What does progesterone do at moderate/high doses in the early/middle follicular phase?

A

Enhances the negative feedback of natural oestrogen, reducing LH and FSH secretion

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6
Q

What does progesterone do at moderate/high doses during ovulation?

A

Inhibits positive feedback of oestrogen, so no LH surge, so no ovualtion

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7
Q

What does progesterone do at lower doses during ovulation?

A

Does not inhibit LH surge, so ovulation still likely, but will thicken cervical mucus

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8
Q

What are the common methods of contraception?

A
  • Natural
  • Barrier
  • Prevention of ovulation
  • Inhibition of sperm transport
  • Inhibition of implantation
  • Sterilisation
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9
Q

What are the natural methods of contraception?

A
  • Fertility awareness methods
  • Lactational amenorrohea method
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10
Q

What happens in fertility awareness methods?

A

Use of fertility indicators to identify fertile and infertile points of the menstrual cycle

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11
Q

What are the fertility awareness methods of contraception?

A
  • Cervical secretions
  • Basal body temperature
  • Length of menstrual cycle
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12
Q

What is the lactionional amenorrhoea method of contraception?

A

Breastfeeding delays the return of ovulation after childbirth

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13
Q

How long is the lactational amenorrhoea method effective for?

A

Up to 6 months after giving birth

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14
Q

What are the advantages of natural contraception methods?

A
  • No hormones
  • No contraindications
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15
Q

What are the disadvantages of natural contraception methods?

A
  • Not as effective
  • Unreliable
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16
Q

What is barrier contraception?

A

A physical barrier that prevents entrance of sperm into cervix

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17
Q

Give 2 examples of barrier contraception

A
  • Male/female condoms
  • Female diaphragm/cap
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18
Q

What are the advantages of condoms?

A

Can help prevent STIs

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19
Q

What are the disadvantages of male condoms?

A

Sensitivity/allergy to latex

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20
Q

What are the disadvantages of female condoms?

A

Not as widely available

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21
Q

What are female diaphragms/caps also used with?

A

Spermicide

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22
Q

What are the advantages of female diaphragms/caps?

A

Can be inserted anytime, so additional chemical barrier

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23
Q

What are the disadvantages of female diaghragms/caps?

A

Need to use with spermicide, which can cause local reaction

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24
Q

What methods of contraception prevent ovulation?

A
  • Combined oral contraceptive pill
  • Progesterone depot
  • Progesterone implant
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25
Q

How can progesterone prevent ovulation?

A

At moderate/high doses, it inhibits the positive feedback of oestrogen, so no LH surge, so no ovulation

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26
Q

What does the combined oral contraceptive pill (COCP) contain?

A

Combination of oestrogen and progesterone

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27
Q

When is the COCP taken?

A

Either for 21 days, followed by 7 day break, or 28 days with 7 days of ‘dummy’ pill

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28
Q

What is the principal action of the COCP?

A

To prevent ovulation

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29
Q

What is the secondary action of the COCP?

A
  • Reduced endometrial receptivitiy to inhibit implantation
  • Thickens cervical mucus to inhibit penetration of sperm
30
Q

What are the advantages of COCP?

A
  • Can relieve menstrual disorders
  • Reduces risk of ovarian cysts and cancer
31
Q

What are the disadvantages of the COCP?

A
  • User dependant
  • Side effects
  • Increases risk of certain conditions
32
Q

What are the side effects of COCP?

A
  • Breakthough bleeding
  • Breast tenderness
  • Mood disturbance
33
Q

What does COCP increase the risk of?

A
  • Venous thromboembolism
  • Myocardial infarction
34
Q

What is in a prosterone depot?

A

Synthetic progesteron

35
Q

How is a progesterone depot administered?

A

Via subcutaneous/intramuscular injection, which is slowly released into the systemic circulation

36
Q

How long does a progesteron depot last?

A

8-13 weeks

37
Q

What is the principle action of a progesteron depot?

A

Prevent ovulation

38
Q

What are the secondary actions of progesterone depots?

A
  • Thickens cervical mucus to inhibit penetration of sperm
  • Reduces endometrial receptivity to inhibit implantation
39
Q

What are the advantages of a progesterone depot?

A
  • Convenient
  • Can relieve menstrual disorders
40
Q

What are the disadvantages of a progesterone depot?

A
  • Altered and irregular bleeding is common
  • Delayed return of fertility for up to 1 year after stopping
  • Not quickly reversible
  • Small loss of bone mineral density, and possible increase fracture risk
41
Q

What is a progesterone implant?

A

A progesterone containing 4cm flexible rod implant that is inserted sub-dermally in upper arm

42
Q

How long does the progesterone implant work for?

A

Can work for up to 3 years

43
Q

What is the principle action of the progesterone implant?

A

Prevent ovulation

44
Q

What are the secondary actions of the progesterone implant?

A
  • Reduce endometrial receptivity to inhibit implantation
  • Thickens cervical mucus to inhibit penetration of sperm
45
Q

What are the advantages of the progesterone implant?

A
  • Long duration of action
  • Convenient
  • Can relieve menstrual disorders
46
Q

What are the disadvantages of the progesterone implant?

A
  • Small procedure required to fit and remove the implant
  • Local adverse effects can occur
  • Can cause changes in bleeding pattern
47
Q

What methods of contraception inhibit sperm transport?

A
  • Progesterone only pill
  • Secondary action of other contraceptives
48
Q

What will progesterone do at lower doses?

A

Does not inhibit the LH surge, so ovulation still likely, but will thicken cervical mucus

49
Q

How does the progesterone only pill compare to other contraceptive methods?

A

It has a lower dose of progesterone

50
Q

What does the progesterone only pill do?

A

Thickens the cervical mucus, making it impenetrable to sperm

51
Q

What are the advantages of the progesterone only pill?

A

Can be used where the COCP is contraindicated

52
Q

What are the disadvantages of the progesterone only pill?

A
  • Menstrual problems are common
  • Must be taken at the same time each day
53
Q

What is the error for forgotton progesterone only pill?

A

Only 3 hours late

54
Q

What contraceptive methods is inhibition of sperm transport a secondary action of?

A
  • COCP
  • Progesterone depot
  • Progesterone implant
  • Intrauterine system
55
Q

What methods of contraception inhibit implantation?

A

Intrauterine device

56
Q

What is a intrauterine device?

A

A small device made of plastic with added copper that is placed in the uterus

57
Q

What is the principal action of an intrauterine device?

A

Copper is toxic to sperm and ovum, which prevents fertilisation

58
Q

What are the secondary actions of an intrauterine device?

A
  • Convenient
  • Long duration of action
  • Emergency contraception
59
Q

How long does an intrauterine device last?

A

5-10 years

60
Q

When can an intrauterine device be used as emergency contraception?

A

Up to 5 days after unprotected intercourse

61
Q

What are the disadvantages of an interuterine device?

A
  • Insertion may be unpleasant
  • IUD displacement/expulsion may occur
  • Periods may be heavier, longer, and more painful
  • Risk of uterine perforation is 2/1000 insertions
62
Q

What is the male sterilisation procedure called?

A

Vasectomy

63
Q

What happens in a vasectomy?

A

Vas deferens are interrupted to prevent sperm entering the ejaculate. Done under local anaesthetic

64
Q

What much be done after a vasectomy?

A

Must conform success by post-operative semen analysis to confirm no sperm in the ejaculate

65
Q

When is a post-vasectomy semen analysis done?

A

12-16 weeks after surgery

66
Q

What are the advantages of a vasectomy?

A
  • Pernament
  • No hormonal side effects
67
Q

What are the disadvantages of a vasectomy?

A
  • Failure rate 1/2000
  • Should not be done if any doubt about having chidren in the future
68
Q

What is the female sterilisation procedure?

A

Tubal ligation/clipping

69
Q

What happens in tubal ligation/clipping?

A

Fallopian tubes are cut or blocked to stop the ovum travelling down from the ovary to the uterus. Done under local or general anasthetic

70
Q

What are the advantages of tubal ligation/clipping?

A
  • Permanent
  • No hormonal side effects
71
Q

What are the disadvantages of tubal ligation/clipping?

A
  • Failure rate 2-5/1000
  • Should not be chosen if any doubt about having children in the future

ESA 4 - Reproductive System (31 decks)

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