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Reproduction SOH > Contraception > Flashcards

Contraception Flashcards

1
Q

Which survives longer in the female genital tract - sperm or ovum?

A

Sperm

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2
Q

How long can sperm live in female genital tract?

A

up to 5 days

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3
Q

How long can ovum survive in the female genital tract?

A

Up to 24 hours

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4
Q

Name 3 types of combined hormonal contraception (CHC)?

A

Pill
Patches
Vaginal ring

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5
Q

Name 3 types of progesterone only contraception (POC)?

A

Pill
Implant
Depo injection

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6
Q

Name 7 broad categories of contraception?

A 
Combined hormonal contraception (CHC)
Progesterone only contraception (POC)
Intra uterine system (IUS)
Intra uterine device (IUD) 
Barrier methods 
Sterilisation
Emergency contraception
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7
Q

If a patient wants quick starting contraception (i.e. they don’t want to wait until next period before starting contraception) then they could get…

A

Some CHCs
POP
Implant

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8
Q

If a patient wants quick starting contraception (i.e. they don’t want to wait until next period before starting contraception) then they CANNOT get ….

A

IUD - copper coil

Pills containing cyproterone acetone

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9
Q

Uses of contraceptives

A 
Contraception
Heavy menstrual bleeding 
Painful periods 
Irregular periods 
Premenstrual symptoms 
Endometriosis
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10
Q

Name 4 short acting methods of contraception

A

Combined hormonal contraception
Progesterone only pill
Condoms
Diaphragms

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11
Q

Whats more effective: long acting or short acting methods of contraception? why is this?

A

Long acting

= they don’t rely on routine and continuous compliance

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12
Q

Name 4 long acting methods of contraception

A

Implant
Copper IUD
IUS
Sterilisation

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13
Q

What is the most effective method of contraception?

A

Progesterone only implant

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14
Q

How often should you check the patients history when they are on contraception?

A

Annually

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15
Q

Before prescribing contraception: what is needed?

A 
History 
Examination
- Must report BP 
- Must record BMI 
- Vaginal exam (if Intra uterine method is used)
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16
Q

CHC - which hormones does it contain?

A

Oestrogen and progestogen

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17
Q

CHC - mode of action

A

Primarily inhibits ovulation

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18
Q

CHC - causes THIN/THICK cervical mucous and THIN/THICK endometrium?

A

Thick cervical mucous
Thin endometrium
(this reduces the likelihood of getting pregnant)

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19
Q

CHC - failure rate

A

Pearl index 0.2%

higher failure rate if people forget to take it

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20
Q

CHC - Protects against which cancers?

A

Ovarian and endometrial cancer

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21
Q

CHC worsens acne. True or false?

A

False

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22
Q

CHC - Pill - example

A

Rigavedon 30mcg

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23
Q

What is one of the most commonly used contraceptive methods in the UK ?

A

Combined oral contraceptive pill

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24
Q

CHC - pill - how/when to take it?

A

Start in first 5 days of regular menstruation

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25
Q

CHC - Can you take the pill at any time of the menstrual cycle?

A

Yes

  • when reasonably sure you are not pregnant
  • use condoms for first 7 days after starting pill
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26
Q

CHC - pill - regimen

A

Take daily for 21 days followed by 7 day break

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27
Q

CHC - can you use the pill continuously?

A

Tri-cycling - you can take 3 packs of pill back to back then have 4-7 days off (NEVER have more than 7 days off)

Extended use - use continuously until breakthrough bleeding occurs then stop for 4-7 days

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28
Q

CHC - pill - unwanted effects

A 
Venous thrombosis 
Arterial thrombosis 
Systemic hypertension 
- small increase in BP in some people
- withdraw if BP >140/90
Adverse effects on some cancers
- breast cancer
- cervical cancer (long term use)
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29
Q

CHC - pill - when should BP be checked?

A

Before initiating
3 months after starting
Annually thereafter

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30
Q

CHC - pill - contraindications

A

Migraine with aura (increases risk of ischaemic stroke)

Rifampicin drug

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31
Q

CHC - how long does vaginal ring last?

A

3 weeks

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32
Q

CHC - patch - contraindications

A

If you weigh over 90kg

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33
Q

POC - pill - mode of action

A

Causes thick cervical mucous, thin endometrium and reduces fallopian tube transport

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34
Q

POC - pill - how to start

A

Start on day 1-5 of period

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35
Q

POC - pill - can you start at any time of menstrual cycle?

A

Yes

  • if reasonably certain you are not pregnant
  • use condoms for first 7 days
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36
Q

POC - implant - how long does it provide contraception for?

A

Up to 3 years

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37
Q

POC - implant - mode of action

A

Inhibits ovulation

Causes thick cervical mucous and thin endometrium

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38
Q

POC - implant - example

A

Nexaplanon

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39
Q

POC - implant - insertion

A

Sub dermal

Upper arm

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40
Q

POC - implant - failure rate

A

Pearl index - 0.05%

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41
Q

POC - implant - complications

A

Irregular periods

Some people get spotting

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42
Q

POC - depo injection - how often is it administered?

A

Every 13 weeks

43
Q

POC - depo injection - mode of action

A

Inhibits ovulation
Causes FSH suppression
- which suppresses estradiol levels
- causes thick cervical mucous and thin endometrium

44
Q

POC - depo injection - examples (2)

A

Depo-provera

Sayana press

45
Q

POC - depo injection - failure rate

A

Pearl index 0.2%

46
Q

IUS - definition

A

Coil

Works as soon as its inserted

47
Q

IUS - how long does it last?

A

5-10 years

48
Q

IUS - mode of action

A

Insert into vagina (T shaped)
Releases progestogen into the womb to prevent you from getting pregnant
Causes thick cervical mucous and thin endometrium

49
Q

IUS - can it be inserted at any time in the menstrual cycle?

A

Yes….if

  • no unprotected sex in past 3 weeks
  • no unprotected sex since last menstrual period
  • pregnancy is excluded
50
Q

IUS - name 3 examples

A

Mirena
Kyleena
Jaydess

51
Q

IUS - which one do you use if someone has a particularly small uterus?

A

Jaydess

52
Q

IUD - definition

A

T shaped copper coil that is inserted into the vagina

53
Q

IUD - mode of action

A

Does not release hormones
Copper released as it is toxic to an egg and sperm joining
Therefore, it prevents fertilisation

54
Q

IUD - can it be started at any time of the menstrual cycle?

A

Yes…if

  • no unprotected sex in past 3 weeks
  • no unprotected sex since last menstrual period
  • not pregnant
55
Q

IUD - disadvantages

A

Positioning

- if not fitted in correct location, a pregnancy could form above it

56
Q

A copper coil can be used as emergency contraception. True or false?

A

True

57
Q

Name 2 barrier methods

A

Condoms

Diaphram

58
Q

Barrier methods - diaphragm

A

Sits over the cervix and prevents spree from entering

59
Q

Barrier methods - how long should diaphragm stay in after sex?

A

6 hours

60
Q

Sterlisation is a reversible form of contraception. True or false?

A

False

- non-reversible

61
Q

Female sterilisation - method

A

Block fallopian tubes

Must make sure patient is not pregnant

62
Q

Male sterilisation - method

A

Vasectomy

Division of vas deferens so it stops sperm from getting up the vas deferens

63
Q

Natural family planning

A

Woman monitors and records a number of fertility signals during menstrual cycle to either plan/avoid pregnancy

64
Q

Natural family planning - which fertility signals are monitored?

A 
Basal body temperature 
Cervical mucous
Cervical position 
Standard days 
Breast feeding
65
Q

Natural family planning - basal body temperature

A

Taken before rising in morning
There is an increase in basal body temperature after ovulation
This increased temp is sustained for 3 days

66
Q

Natural family planning - cervical mucous

A

Watery, thin, slippery - just before ovulation

Thick,moist, creamy - post ovulation

67
Q

Natural family planning - cervical position when fertile

A

Cervix is high in vagina, soft and open

68
Q

Natural family planning - cervical position when less fertile?

A

Cervix is low in vagina, firm and closed

69
Q

In a 28 day regular cycle, which days are most fertile?

A

days 8 -> 18

70
Q

It is possible to be fertile ___ days before and ___ days after ovulation ?

A

5

71
Q

You are unlikely to get periods if you breast feed exclusively and baby is under 6 months. True or false?

A

True

72
Q

Natural family planning - 3 criteria for lactational amenorrhoea

A

Exclusive breast feeding
Less than 6 months post delivery
Amenorrhoeic

73
Q

Cyproterone acetate

A

Not a contraceptive but acts as a contraceptive.

Used for acne and hirsutism treatment

74
Q

Emergency contraception - When can it be used

A

Up to 5 days after unprotected sex

Can be used within 5 days of predicted ovulation date

75
Q

What do you do if you miss more than 1 COC pill ?

A

emergency contraception

76
Q

What do you do if patch/ring has been out for more than 48 hours?

A

Emergency contraception

77
Q

Emergency contraception - intrauterine option

A

Copper IUD

78
Q

What is the most effective form of emergency contraception?

A

Copper IUD

79
Q

Emergency contraception - Copper IUD - when can it be inserted?

A

Up to 5 days after unprotected sex OR

Up to 5 days after earliest expected date of ovulation

80
Q

Emergency contraception - name 2 oral options

A 
Levonorgestrel (LNG) 
Ulipristal acetate (UPA)
81
Q

Emergency contraception - LNG - when can you use it

A

Up to 72 hours after unprotected sex

82
Q

Emergency contraception - LNG - mode of action

A

High dose progestogen
Delays ovulation
Works before LH surge

83
Q

Emergency contraception - LNG - what happens to the dose if BMI is over 26

A

double dose required

84
Q

Emergency contraception - UPA - when can you use it

A

Up to 120 hours after unprotected sex

85
Q

Emergency contraception - UPA - mode of action

A

Anti-progestogen
Delays ovulation
Works until after start of LH surge

86
Q

Emergency contraception - UPA - what happens to the dose if BMI is over 26

A

Same dose

87
Q

Emergency contraception - which oral form is more effective?

A

UPA

88
Q

Emergency contraception - which oral form is most cost effective?

A

LNG

89
Q

When should you not use UPA as emergency contraception?

A

If you are also wishing to quick start hormonal contraception
- As UPA is anti-progestogen you may stop the ongoing contraception from working

If patient has acute severe asthma

90
Q

Bleeding patterns with contraceptives - Scheduled bleeding

A

menstruation or regular withdrawal bleeding

91
Q

Bleeding patterns with contraceptives - breakthrough bleeding

A

Unscheduled bleeding

92
Q

Bleeding patterns with contraceptives - amenorrhoea

A

No bleeding or spotting in a 90 day period of time

93
Q

Bleeding patterns with contraceptives - spotting

A

Vaginal discharge containing blood

94
Q

Pearl index

A

Represents the number of contraceptive failures per 100 woman users per year

95
Q

When to take a pregnancy test?

A

3 weeks after last unprotected sex

96
Q

What is the most commonly used contraception method worldwide?

A

Withdrawal

- have sex without condom and pull out before ejaculation

97
Q

When can you be reasonably certain that patient is not pregnant?

A

No sex since last period
Crorrectly using reliable contraception
Within first 7 days of the onset of a normal menstrual period
Within 4 weeks postpartum in non breastfeeding women
Within 6 months postpartum in exclusively breastfeeding women

98
Q

Exclusively breast feeding + baby under 6 months. Is breastfeeding alone good enough contraception?

A

Yes

99
Q

What is the new self injectable contraception ?

A

Syanapress

100
Q

Can’t use COCP within X weeks of pregnancy?

A

6

101
Q

POP can be given immediately postnataly. True or false?

A

True

102
Q

Which type of pill gives you most ‘regular periods’

  • COCP
  • POP
A

COCP

103
Q

Depo-provera takes X months before fertility returns?

A

12 months

Reproduction SOH (50 decks)

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