Contraception Flashcards
How effective of the combined pill?
Over 99%
What are the 2 hormones in the combined pill?
Ethinyl oestradiol
Synthetic progesterone
What is the normal dose of the combined pill?
20-35 micrograms
What is the mode of action of the combined pill?
Prevents ovulation by altering FSH and LH to prevent surge
Prevents implantation as provides inadequate endometrium
Inhibits sperm penetration of cervical mucus by changing quality and character
How do you take the combined pill?
Start at any time if not pregnant
Use barrier contraception for 7 days
Can use up to 3 months continuously
What are the non contraceptive benefits of the combined pill?
Regular bleed with potential reduction in painful heavy periods and anaemia
Reduction in functional ovarian cysts
50% reduction in ovarian and endometrial cancer
Improvement in acne
Reduction in benign treat disease, rheumatoid arthritis, colon cancer and osteoporosis
What are the risks of the combined pill?
Increased risk of venous thromboembolism and cervical cancer
What is the effect of the combined pill on the risk of venous thromboembolism?
Triples
What is the effect of the combined pill on the risk of cervical canecr>
Doubles with 10 years use
WHow effective id the progesterone only pill?
99% but user dependent
What is the mode of action and dose of the progesterone only pill>
Cervical mucus becomes impenetrable
75 micrograms
When is the progesterone only pill at its most effective?
48 hours after use
What is the window for taking the progesterone only pill?
Within 3 hours of same time every day
What is the “injection”?
Depot medrocyprogesterone acetate injection
How effective if the depot injection?
Over 99%
What is the mode of action of the depot injection?
Prevents ovulation
Alters cervical mucus
Prevents implantation by rendering endometrium unsuitable;le
What are the benefits of the depot injection?
Oestrogen free
Good for forgetful pill takers
What are the risks of the depot injection?
Delay in resturn o fertility
Reversibe reduction in bone density
Problematic bleeding
Weight gain
What is the subdermal implant comprised of?
68mg of progesterone etongestrel in EVA matrix cover in rate controlling membrane
What is the mode of action of the implant?
Primary- inhibit ovulation
Secondary- effect on cervical mucus
What are the 2 types of IUD?
Copper
Mirena
What is the mode of action of the copper coil?
Irritates endometrium
Spermicide
Alters cervical mucus
What is the mode of action of the Mirena coil?
Alters cervical mucus
Can prevent ovulation
What are the methods of barrier contraception?
Condom
Female condom
Diaphragm
Cervical cap
What is the lifetime failure rate of female sterilisation?
1 in 500
What is the lifetime failure rate of vasectomy?
1 in 2000
Why is pain common after a vasectomy?
Sperm granuloma, a mass of degenerating spermatozoa surrounded by macrophages
What are the options for emergency contraception?
Copper IUD- most effective
Levonogestrel aka Levonelle
ellaOne
When can Levonelle be used?
1.5mg within 72 hours
When can ellaOne be used?
30mg within 120 hours
When can the copper coil be used as emergency contraception?
Within 5 days, or up to 5 days after the earliest time one could have ovulated
What are the 2 types of abortion?
Medical
Surgical
What % of abortions are medical?
> 80%
What is the method of action of a medical abortion?
Mifepristone switches off pregnancy hormone and causes uterus to contract
48 hours later, prostaglandin initiated uterine contraction to open cervix and expel pregnancy
What are the indications for abortion?
The pregnancy has not exceeded 24 weeks and continuation of the pregnancy would cause greater harm to the physical or mental health of the woman and/or her existing children than if the pregnancy were terminated
Medical- foetal abnormality or maternal health
What should be discussed in a consultation pre abortion?
Consult on methods
Offer counselling for after termination
FBC and self obtained swab for chlamydia and gonorrhoea, and STI bloods offered
Advise on prolonged bleeding
What are the possible complications of abortion?
Failure Haemorrhage Infection Prolonged bleeding Uterine perforation Cervical trauma Retained products of conception Decreased fertility
What is the likelihood of failure of termination?
<5 in 100
What is the likelihood of haemorrhage or prolonged bleeding after termination?
<5 in 100
