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Repro AM > Contraception > Flashcards

Contraception Flashcards

1
Q

How effective of the combined pill?

A

Over 99%

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2
Q

What are the 2 hormones in the combined pill?

A

Ethinyl oestradiol

Synthetic progesterone

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3
Q

What is the normal dose of the combined pill?

A

20-35 micrograms

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4
Q

What is the mode of action of the combined pill?

A

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

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5
Q

How do you take the combined pill?

A

Start at any time if not pregnant
Use barrier contraception for 7 days
Can use up to 3 months continuously

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6
Q

What are the non contraceptive benefits of the combined pill?

A

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

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7
Q

What are the risks of the combined pill?

A

Increased risk of venous thromboembolism and cervical cancer

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8
Q

What is the effect of the combined pill on the risk of venous thromboembolism?

A

Triples

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9
Q

What is the effect of the combined pill on the risk of cervical canecr>

A

Doubles with 10 years use

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10
Q

WHow effective id the progesterone only pill?

A

99% but user dependent

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11
Q

What is the mode of action and dose of the progesterone only pill>

A

Cervical mucus becomes impenetrable

75 micrograms

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12
Q

When is the progesterone only pill at its most effective?

A

48 hours after use

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13
Q

What is the window for taking the progesterone only pill?

A

Within 3 hours of same time every day

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14
Q

What is the “injection”?

A

Depot medrocyprogesterone acetate injection

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15
Q

How effective if the depot injection?

A

Over 99%

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16
Q

What is the mode of action of the depot injection?

A

Prevents ovulation
Alters cervical mucus
Prevents implantation by rendering endometrium unsuitable;le

17
Q

What are the benefits of the depot injection?

A

Oestrogen free

Good for forgetful pill takers

18
Q

What are the risks of the depot injection?

A

Delay in resturn o fertility
Reversibe reduction in bone density
Problematic bleeding
Weight gain

19
Q

What is the subdermal implant comprised of?

A

68mg of progesterone etongestrel in EVA matrix cover in rate controlling membrane

20
Q

What is the mode of action of the implant?

A

Primary- inhibit ovulation

Secondary- effect on cervical mucus

21
Q

What are the 2 types of IUD?

A

Copper

Mirena

22
Q

What is the mode of action of the copper coil?

A

Irritates endometrium
Spermicide
Alters cervical mucus

23
Q

What is the mode of action of the Mirena coil?

A

Alters cervical mucus

Can prevent ovulation

24
Q

What are the methods of barrier contraception?

A

Condom
Female condom
Diaphragm
Cervical cap

25
Q

What is the lifetime failure rate of female sterilisation?

A

1 in 500

26
Q

What is the lifetime failure rate of vasectomy?

A

1 in 2000

27
Q

Why is pain common after a vasectomy?

A

Sperm granuloma, a mass of degenerating spermatozoa surrounded by macrophages

28
Q

What are the options for emergency contraception?

A

Copper IUD- most effective
Levonogestrel aka Levonelle
ellaOne

29
Q

When can Levonelle be used?

A

1.5mg within 72 hours

30
Q

When can ellaOne be used?

A

30mg within 120 hours

31
Q

When can the copper coil be used as emergency contraception?

A

Within 5 days, or up to 5 days after the earliest time one could have ovulated

32
Q

What are the 2 types of abortion?

A

Medical

Surgical

33
Q

What % of abortions are medical?

A

> 80%

34
Q

What is the method of action of a medical abortion?

A

Mifepristone switches off pregnancy hormone and causes uterus to contract
48 hours later, prostaglandin initiated uterine contraction to open cervix and expel pregnancy

35
Q

What are the indications for abortion?

A

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

36
Q

What should be discussed in a consultation pre abortion?

A

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

37
Q

What are the possible complications of abortion?

A 
Failure
Haemorrhage
Infection
Prolonged bleeding
Uterine perforation
Cervical trauma
Retained products of conception
Decreased fertility
38
Q

What is the likelihood of failure of termination?

A

<5 in 100

39
Q

What is the likelihood of haemorrhage or prolonged bleeding after termination?

A

<5 in 100

Repro AM (27 decks)

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