Contraception Flashcards
Give the mode of action for COCP
Inhibits ovulation
opposes oestrogen effects of endometrial proliferation
Give the mode of action for POP (excluding desogestrel)
thickens cervical mucus
Give the mode of action for desogestrel only POP
Primary: inhibits ovulation
Also thickens cervical mucus
Give the mode of action for Depot, what hormone does it have
Primary: inhibits ovulation
Also: thickens cervical mucus
Medroxyprogesterone acetate
Give the mode of action for IUD
decreases sperm motility and survival
inhibits implantation
Give the mode of action for IUS
what is it also know as
Primary: prevents endometrial proliferation
also: thickens cervical mucus
How does levonorgestrel work
inhibits ovulation
how does ulipristal work, what contraceptive is it?
Ella one - morning after pill
Inhibits ovulation
What is the age of consent?
16
Give the Fraser guidelines?
- understands advice
- cannot be persuaded to tell parents
- likely to continue having unprotected sex
- physical, MH likely to suffer from no rx
- their best interests
What are long acting reversible contraceptives?
implant
injection
IUS - levonorgestrel
IUD
What are short acting reversible contraceptives?
COCP
POP
Combined transdermal patch
Combined contraceptive vaginal ring
What is the failure rate of POP
0.3%
What is the failure rate of Depo
0.2%
What is the failure rate of the implant
0.05%
What are adverse effects of progesterone only contraceptives?
Menstrual irregularities
Breast tenderness
Ovarian cysts
increased risk of breast cancer
What is the failure rate of COCP
0.3%
What are barrier methods of contraception
Male and female condoms.
Diaphragms and caps.
Spermicides.
Why are condoms w pre-lubricated spermicide not recommended?
increase transmission of blood-borne infections such as HIV, hep b/c
What are advantages of male condoms
Protect against STIs and cervical cancer
What are disadvantages of male condoms
less effective
can break and slip off
interrupts sex
loss of sensitivity
What are advantages and disadvantages of female condoms?
Adv: reduce risk of some STIs + CC disadvantages: can be dislodged or penis inserted in wrong bit noisy
What is failure rate w typical use of male condom?
18%
What is failure rate w perfect use of male condom?
2%
What is a disadvantage of diaphragms?
may not reduce risk of STIs
How should a woman be started on COCP?
day 1 of the menstrual cycle
What are advantages of COCP
Lighter, regular less painful periods,
reduced risk of ovarian, endometrial cancer
What does the implant contain?
etonogestrel
What is failure rate of IUS
0.2%
What is failure rate of IUD?
0.8%
If a woman has IUS and PID, what is management
don’t need to remove IUS, can test for organism and start abx treatment
How long can IUS stay in?
3-5 years
What is a disadvantage of IUS?
acne headaches and unscheduled bleeding in the first 3-6months of using it
When does lactational amenorrhoea method work?
<6m post-partum
if fully breastfeeding
has to be amenorrhoeic
Which contraceptive has evidence for weight gain?
the injection
Which contraceptive causes a delay in returning to fertility after stopping?
injection
Which contraception requires monitoring of BMD and when
Depot when under <18yr due to association with reduction in BMD
What are options for emergency contraception?
Progesterone pill - Ellaone or Levonelle
IUD
When can IUD be used as emergency contraception?
within first 5 days
What does Ellaone contain?What is the window for which it can be used as emergency contraception?
ulipristal acetate
120hr
What does Levonelle contain? What is the window for which it can be used as emergency contraception?
levonorgestrel
72 hrs
What are permanent methods of contraception?
Vasectomy
Tubal occlusion
Which permanent method can be reversed? what are success rates?
vasectomy AND occlusion!
40-97% for vasectomy
31-92 for occlusion
when are vasectomys confirmed as effective?
12 weeks to confirm azoospermia
What does tubal occlusion increase the risk of ?
ectopic pregnancies
What is lifetime failure rate of occulsion
1 in 200
