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Reproduction Year 3 > Contraception > Flashcards

Contraception Flashcards

1
Q

what does the natural family planning method take into account to work as contraception

A
  1. basal body temperature
  2. cervical mucous
  3. cervical position
  4. ‘standard days’
  5. breast feeding
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2
Q

what does cervical mucous tell you about ovulation

A

thick + sticky post ovulation

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3
Q

what does the cervical position tell you about ovulation

A

when fertile the cervix is high, soft + open

when less fertile the cervix is low, firm + closed

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4
Q

most fertile days

A

day 8-18 in a 28 day cycle

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5
Q

what criteria is needed to know that breast feeding is working as a contraceptive

A

exclusive breast feeding
less than 6 months post natal
amenorrhoeic

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6
Q

what is LARC + examples

A

Long acting reversible contraception

E.g. depo provera IM injection

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7
Q

what is VLARC + examples

A

Very long acting reversible contraception

e.g. IUD, IUS, implant

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8
Q

how does depo provera injection work

A

inhibits ovulation

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9
Q

when is the depo provera injection given

A

every 13 weeks

lasts 14 weeks

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10
Q

what hormones does the depo injection contain

A

progesterone only

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11
Q

side effects of depo injection

A

irregular bleeding, weight gain, osteoporosis, delay in return of fertility

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12
Q

what needs to be checked before depo injection is prescribed

A

BP, BMI, risks for osteoporosis

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13
Q

risk factors for osteoporosis

A 
underweight / anorexia 
prolonged steroid use
excess alcohol intake
immobility
family history 
smoking
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14
Q

when can you start depo injection

A

up to + including day 5 with no additional need for contraception
Any other time providing she is not pregnant + will need to use additional contraception for 7 days

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15
Q

what is different about the IUD

A

it is non-hormonal

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16
Q

how does an IUD work

A

prevents fertilisation- decreases sperm motility + survival

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17
Q

side effects of IUD

A

Longer, heavier, more painful periods

small chance of infection

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18
Q

when can IUD be inserted

A

up to 5 days after unprotected sex (immediately effective)

up to 5 days after ovulation

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19
Q

what hormone does IUS contain

A

progesterone only

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20
Q

how does an IUS work

A

stops implantation

thickens cervical mucous

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21
Q

side effects of IUS

A

Irregular bleeding
lighter periods
infection

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22
Q

when can an IUS be inserted

A

within first 7 days of cycle- no contraception needed

if after first 7 days, additional contraception is needed for 7 days

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23
Q

contraindications to IUD/IUS

A

current pelvic infection
abnormal uterine anatomy
pregnancy
Endometrial/cervical carcinoma

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24
Q

what should be checked before fitting an IUD/IUS

A

PV to check uterine size/position

BP and pulse

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25
Q

what is the implant

A

a single, non biodegradable subdermal rod

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26
Q

how does the implant work

A

inhibits ovulation

27
Q

what hormone does the implant release

A

progesterone only

28
Q

how long does the implant last

A

3 years

29
Q

when can the implant be fitted

A

within first 5 days of cycle
up to day 5 post 1/2 trimester abortion
on of before day 21 post partum

30
Q

side effects of the implant

A

irregular bleeding
weight gain
acne
nerve damage/vascular injury on insertion

31
Q

what does the combined oral contraceptive pill contain

A

oestrogen + progesterone

32
Q

how does the combined pill work

A

inhibits ovulation
thickens cervical mucous
makes endometrium unfavourable for implantation

33
Q

side effects of the combined pill

A

increased risk of venous thromboembolism
increased risk of breast + cervical carcinoma
increased BP

34
Q

The combined pill contains 21 pills- how does the system work

A

first 7 pills inhibit ovulation

remaining 14 maintain anovulation

35
Q

advice for someone who misses one combined pill

A

If over 24 hours but less than 48 hours, take the pill ASAP
Take remainder of pack as normal
no emergency contraception is required

36
Q

advice for someone who misses two or more combined pills

A

> 48 hours since last pill, take the most recent pill + remainder of pills at the correct time
Use condoms/abstain until 7 pills have been taken consecutively

37
Q

through what mechanism does the combined pill stop ovulation

A

acts on hypothalamic-pituitary-ovarian axis traduce LH/FSH

38
Q

what hormones does the patch contain

A

combined oestrogen + progesterone

39
Q

how does the patch work

A

patch worn for 1 week to suppress ovulation
patch reapplied weekly for 2 weeks
4th week is patch free to allow withdrawal bleed

40
Q

main side effect of the patch

A

withdrawal bleed may be painful

41
Q

how does the vaginal ring work

A

ring placed in vagina for 21 days

ring free interval for 7 days to allow withdrawal bleed

42
Q

side effects of vaginal ring

A

acne
irritability
mood changes

43
Q

contra-indication for combined oral contraceptive

A

MIGRAINE WITH AURA

44
Q

what is a migraine with aura

A

a ‘change’ occurring 5-20 mins before onset of headahce

may be visual, altered smell, taste, hemiparesis

45
Q

protective effects of combined oral contraceptive therapy

A

decreased risk of endometrial and ovarian cancer
improves acne
lighter periods

46
Q

what is cyproterone acetate

A

works as a combined oral contraceptive used in treatment of acne + hirsutism

47
Q

what types of progesterone only pills are there

A

new- etonorgestrel

old- levonorgestrel

48
Q

primary action of progesterone only pills

A

thicken cervical mucous

49
Q

action of newer progesterone only pills

A

inhibit ovulation

50
Q

what do progesterone only pills interact with

A

Liver enzymes- inducers of cytochrome P450

51
Q

How are progesterone only pills taken

A

same time every day, no break

52
Q

what happens if someone misses a progesterone only pill + has unprotected sex

A

emergency contraception + 2 days extra contraception

53
Q

How many doctors need to sign the HSAI form for an abortion to happen legally

A

2

54
Q

what are the two types of abortion and their time frame in NSH tayside

A

surgical termination- up to 12 weeks

medical termination- up to 18 weeks + 6 days

55
Q

grounds for emergency termination

A

necessary to save the life of the woman

necessary to prevent serious permanent injury to the physical/mental health of the woman

56
Q

for a medical termination, what are the 3 time frames

A

early- up to 9 weeks
late- 9-12 weeks
mid-trimester- 12-24 weeks

57
Q

what are the stages of a medical termination

A
  1. oral mifepristone 200mg (anti-progesterone)

2. 24-48 hours later give vaginal prostaglandin e.g misoprostol

58
Q

what are the methods of surgical termination

A

vacuum aspiration- 6-12 weeks

dilatation and evacuation- 13-24 weeks (not available in Scotland)

59
Q

what is required before a surgical termination of pregnancy

A

cervical priming with vaginal prostaglandin

60
Q

risks of surgical termination

A

Pain, haemorrhage, infection, failure procedure, cervical trauma, uterine perforation

61
Q

methods of emergency contraception

A

Oral: levonelle, ella one
Intrauterine: copper IUD

62
Q

What time frame can levonelle be given

A

up to 72 hours post unprotected sex

63
Q

what time frame can Ella one be given

A

up to 120 hours post unprotected sex

64
Q

what time frame can IUD be inserted

A

up to 120 hours post unprotected sex

Reproduction Year 3 (36 decks)

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