Contraception Flashcards
What is the role of progesterone?
At moderate/high doses porgesterone enhances the engative feedback o normal oestrogen which reduce FSH and LH, there is no LH surge and therefore no ovulation
Lower doses of progesterone will not prevent ovulation but will thickent the cervical mucus
How do you use natural contraception methods?
Uses ferility indicators to find the fertile and infertile parts of the cyckle, including measurements of basal measurements, cervical mucus secretions and the length of the emenstural cycle
What are the advantages of natural contraception?
No hormones and no contraindicators
What are the disadvantages of normal contraception?
No as effective with about a 25% failure rate, and unreliable as mensutratl cycles can be affected by stress
How can you use lactional amenrrhea as a method of contraception?
Breastfeeding dealys the return of ovultion after childbrith, and only effective up to 6 months after giving birht
What is the method of action of the combined oral contracpetive pill?
Includes singificant amounts of oestrogen combined with significant amounts of progesterone, with the principal actions of preventing ovulation and the secondary actions of reducing endometrial receptivity to inhibit implantation, and thickens the cercival mucus to inhibit sperm
What are some of the advantages of methods that prevent ovulation?
Can relieve menstrual problems and reduces the risk of ovarian cysts and cancer
What are some of disadvantages of the combined oral contraceptive pill?
User depednat, side affects that include breakthorugh bleeding, breast tenderness and mood disturbance, and increased risk of venous thromboebolism and myocardila infraction
What are some of the disavantages of the progesterone depot?
Altered and irregualr bleeding is common, and delays the return of ferility upt to 1 year after stopping, is not quickly reversible and there is a small loss of bone density and possible increase in fracture risk
What is the progesterone depot?
Administered via subcutaneous intramuscular injection wiht is slowly released in the systematic circulation, and can last between 8-13 weeks
What is the progesterone implannt?
Progetserone containg 4cm flexible rod, which is inserted subdermally in the upper arm and can last up to 3 years
What are some of the disadvantages of the progesterone implant?
Small prcedure to fit and remove the implant, and local adverse effects can occur, can cause changing in bleeding patterns
What is the method of action of the progesterone only pill?
Thickens the cervical mucus making it impentrable to sperm
What is the mechanisms that the intra uterine system?
Small device made of plastic with added slow release progesterone that is placed in the uterus
What are some of the disadvantages of an IUS? I
Insertion may be unpleasnt, and IUS displacement and expulsion may occur, and menstural irregularity common, and risk of uterine perforation
What is the principal action of the intrauterine device?
Principal action is the copper is toxic to sperm and ovum and prevent fertilisation, and secondary actions of copper causes endometrial inflammatory reaction and prevents implantation, and reduces penetration by sperm due to the effect of copper on cervical mucus
What is the mechanism of performing a vasectomy?
The vas deferns interupted to prevent sperm entering the ejaculate, and performed under local anaesthic, and must confirm success using semen anaylsis
What is the method of tubual ligation in the female?
Fallaopian tubes are blocked to stop the ovum travelling to the uterus, can be done under local or general anaesthic
What is the definaiton of inferitlity?
The fialure of conception in a couple having regular unprotected coitus for one year
What are some of the male factors that can cause inferility?
Idipoathic olgiospermia, varicolcele, abdormal sperm prodcution, hypohtalmic or pitautiry dysfunction, and ductal obstruction
What is the mechanism of clopmiphene?
Blocks oestrogen receptors in the hypothalmus, and perceives a deficeny of osterogen and reduced GnRH which stimalte the anterior pituarity to increase secretions of FSH and LH, and this causes increased follicle development, and this results from postive feedback surge
What are some of the features of polycystic ovary syndrome?
Polycystic ovaries, and features resulting from elevated levels of androgens
What are some of the clincial features of polyctysic ovarys
Hirtuism, acne, obesity, male pattern baldness, and pyshcological
What are som eof the different causes of tubal damage?
Usually the result of inflamaotory scarring of the fallopian tubes, past pelvic infections, previous surgery, endometrosis, and mullerian development abnormality
What is endometriosis?
The presenc eof endometrial tissue in sites other than the uterine cavity and most commonly in the pelvic cavity, and increase prodstagladin production by premenstural and menstural endometric lesions
What are the clinical features of endometrosis?
Dymenorhea- painful periods, dyparura= painful sexual intercourse, chornic pelvic pain and inferility
