Contraception Flashcards
What are the types of contraception?
Natural Barrier Hormonal Prevention of implantation Sterilisation Emergency contraception
How do you chose the right contraceptive?
Safe and preference for the patient
What methods have no user failure?
IUD IUS Progesterone implants Progesterone injections Female and male sterilisation
What methods have any user failure?
Combined oral contraceptive pill Progesterone pill Condom Contraceptive patch Vaginal ring Diaphragm, spermacide Natural family planning
What are the positives of abstinence as a contraceptive?
Only method that is 100% effective
No drugs or hormones
No side effects
What are the negatives of abstinence as a contraceptive?
People may not remain abstinent
Also people may want to have sex
What are the positives of the withdrawal method?
No hormones involved
What are the negatives of the withdrawal method?
Not particularly effective
May not have the self control to withdraw at the right time
There may be sperm in the pre ejaculate
No protection against STIs
What is the action of the amenorrhoea lactation method?
Women are not fertile until 21 days after giving birth- when their menstrual cycle restarts
What are the positives of the barrier method of contraception?
Protection against STIs,
Very effective,
The male condom is widely available
What are the negatives of using a barrier method as contraception?
May not be as romantic
Decrease the sexual pleasure
Danger of expiring
May have an allergy or sensitivity to latex or spermacide
What are the barrier methods?
Female and male condoms
Diaphragm
Vaginal ring
Caps
What are the types of hormonal methods?
Combined oral contraceptive pill
Progesterone depot
Progesterone implant
Low dose progesterone
How does progesterone work as a contraceptive?
At moderate/high doses progesterone enhances negative feedback of oestrogen reducing LH and FSH secretion
At moderate/ high doses progesterone inhibits the positive feedback of oestrogen preventing the LH surge and ovulation
At low doses progesterone thickens the cervical mucus
How does the combined oral contraceptive pill work?
Contains a combination of oestrogen and progesterone
It principally prevents ovulation
But it also- reduces endometrial receptivity to inhibit implantation and thickens cervical mucus to prevent the penetration of sperm
What are the positives of the combined oral cotraceptive pill?
Highly effective
Can relieve menstrual disorders
Reduces risk of ovarian cysts and cancers
Reduces risk of endometrial cancer
What are the disadvantages of using the combined oral contraceptive pill as a contraceptive?
No protection from STIs,
Can’t take it if you have a high BMI, migraines (increases risk of stroke or a family history of breast cancer)
Side effects; breast tenderness, break through bleeding and mood disturbance
Increased risk of breast and cervical cancer, VTE, MI/stroke
How does high dose progesterone work?
Prevents ovulation
Thickens cervical mucus to inhibit penetration of sperm
Prevents endometrial proliferation
Advantages of using the progesterone injection as contraception
Reliable (no user failure)
Does not disrupt sex
Can be used by women who can’t have contraceptive that uses oestrogen
What are the disadvantages of using a progesterone injection as a contraceptive?
Appointment needed every 12 months
Contraindication and side effects
Delay in return of fertility (upto eighteen months)
No STI protection
How long does the progesterone implant work for?
Upto 3 years
How does the progesterone only pill work?
Thickens cervical mucus
What are the advantages of the progesterone only pill?
Quickly reversible
Does not interrupt sexual intercourse
Can be used where the COCP pill cannot
What are the disadvantages of the progesterone only pill?
Very user dependent cannot miss a day Causes menstrual problems(1/3 no periods, 1/3 constant periods, 1/3 normal periods) Interacts with other medication Risk of ectopic pregnancy Does not protect against STIs
How does the IUS work?
Works for 3-5 years
Prevents implantation and reduces endometrial proliferation
Thickens cervical mucus
How does the IUD work?
Plastic device with added copper
Works for 5-10 years
Copper is toxic to eggs and sperm
May cause endometrial inflammation reaction preventing implants tat ion and changes consitantancy of cervical mucus
What are the positives of IUS and IUD as contraceptive devices?
They are convenient
Have a long duration of action
What are the disadvantages of the IUS and IUD as a contraceptive device?
Insertion may be unpleasant, Risk of uterine porforation Menstrual irregularities Don’t prevent STIs Displacement and expulsion may occur
What is the failure rate of a vasectomy
1 in 2000 males
What are the types of emergency contraception?
Emergency IUD- up to 5 days after unprotected sex
Emergency pill with ulipristal acetate- up to 5 days after unprotected sex
Emergency pill with levingestrel- up to 3 days after unprotected sex
