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Repro > Contraception > Flashcards

Contraception Flashcards

1
Q

what is the pearl index?

A

number of contraception failures per 100 women-years of use

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2
Q

what can the life table analysis provide?

A

> information on contraception failure rate over specified time frame
can provide cumulative failure rate for any specific length of exposure

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3
Q

what risks are associated with the combined contraceptive pill?

A

> breast cancer (disappears after 10 years of stopping)
cervical cancer (doubles with 10 years)
venous-thromboembolism

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4
Q

what factors increase the risk for a venous thromboembolism on the combined contraceptive pill/ring/patch?

A 
> BMI 30<
> major surgery
> underlying vascular disease
> postnatally within 21 days
> thrombophilias
> immobility
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5
Q

what is the action of the combined contraceptive pill//ring/patch?

A

prevents ovulation by altering LH and FSH preventing the surge and preventing implantation due to inadequate endometrium
also inhibits sperm penetration of the cervical mucous by altering the character and quality of the mucous

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6
Q

the combined contraceptive pill contains which 2 hormones?

A

> ethinyl estradiol

> synthetic progesterone

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7
Q

how effective is the combined contraceptive pill?

A

99%

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8
Q

what is the dose of the combined contraceptive pill?

A

20-35 microgramm

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9
Q

name 2 second generation combined contraceptive pills

A

> levonorgesterol

> norethisterone

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10
Q

name 2 3rd generation combined contraceptive pills

A

> desogestrel

> gestodene

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11
Q

for how long after the first day of starting the combined pill should barrier methods be used?

A

until day 5

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12
Q

how is the combined pill taken?

A

is taken for 21 days then a 7 day break or can use continuously for 3 months then have a pill free week

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13
Q

what are some non-contraceptive benefits that come with the combined contraceptive pill?

A 
> improve acne
> create a regular period (and reduce painful heavy menstruation)
> decreases functional ovarian cysts
> 50% reduction in ovarian and endometrial cancer
> reduction in osteoporosis
> reduction in colon cancer
> reduction in benign breast disease
> reduction in rheumatoid arthritis
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14
Q

how effective is the progesterone only pill?

A

99% user dependent

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15
Q

what is the mode of action of the progesterone only pill?

A

> cervical mucous is rendered impenetrable by sperm

> spectrum of effects on ovulation

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16
Q

true or false

the effect of the progesterone only pill is lost is more than 3 hours late

A

true

17
Q

when is the maximum effect of the progesterone only pill?

A

48hours after digestion

18
Q

what are the problems with IM injection of the progesterone only contraception?

A

> delay in fertility return
reversible bone density reduction
problem bleeding
weight gain

19
Q

what is the action of IM injection of the progesterone only contraception?

A

> prevents ovulation
alters cervical mucous so it is hostile to sperm
renders endometrium unsuitable stopping implantation

20
Q

a 150mg dose of progesterone only contraception is given IM, how long does it cover?

A

12 weeks

21
Q

what is the action of the progesterone only subdermal implant?

A

primary: inhibits ovulation
secondary: inhibits sperm entry tot he upper repro tract

22
Q

what two inter-uterine options are there?

A

> copper coil

> progesterone

23
Q

what is the action of the copper coil?

A

copper is toxic

24
Q

what is the action of the progesterone IUD?

A

thins the endometrial lining

25
Q

what emergency contraception options are there?

A

> copper IUD (most effective)
levonorgestrel
ellaone

26
Q

how long after unprotected sex is levonorgestrel affective for?

A

72hrs

27
Q

how long after unprotected sex is ellaone affective for?

A

120 hrs

28
Q

after how many weeks does a pregnancy termination need to be referred to England?

A

20 weeks

29
Q

what complications can occur in a medical termination of pregnancy?

A

> prolonged bleeding
failure (<5 in 100)
haemorrhage (<5 in 100)
infection

30
Q

what is the action of a medical termination of pregnancy?

A

mifepristone switches off pregnancy hormone which keeps the uterus from contracting
48hrs later misoprostol initiates uterine contraception opening the cervix and expelling the pregnancy

31
Q

describe female sterilisation

A

laparoscopic traditional tube ligation

32
Q

describe male sterilisation

A

permanent division of the vas deferens

33
Q

what can the side effects of male sterilisation be?

A

> pain due to sperm granuloma

> irreversible

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