Contraception Flashcards
what is the pearl index?
number of contraception failures per 100 women-years of use
what can the life table analysis provide?
> information on contraception failure rate over specified time frame
can provide cumulative failure rate for any specific length of exposure
what risks are associated with the combined contraceptive pill?
> breast cancer (disappears after 10 years of stopping)
cervical cancer (doubles with 10 years)
venous-thromboembolism
what factors increase the risk for a venous thromboembolism on the combined contraceptive pill/ring/patch?
> BMI 30< > major surgery > underlying vascular disease > postnatally within 21 days > thrombophilias > immobility
what is the action of the combined contraceptive pill//ring/patch?
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
the combined contraceptive pill contains which 2 hormones?
> ethinyl estradiol
> synthetic progesterone
how effective is the combined contraceptive pill?
99%
what is the dose of the combined contraceptive pill?
20-35 microgramm
name 2 second generation combined contraceptive pills
> levonorgesterol
> norethisterone
name 2 3rd generation combined contraceptive pills
> desogestrel
> gestodene
for how long after the first day of starting the combined pill should barrier methods be used?
until day 5
how is the combined pill taken?
is taken for 21 days then a 7 day break or can use continuously for 3 months then have a pill free week
what are some non-contraceptive benefits that come with the combined contraceptive pill?
> 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
how effective is the progesterone only pill?
99% user dependent
what is the mode of action of the progesterone only pill?
> cervical mucous is rendered impenetrable by sperm
> spectrum of effects on ovulation
true or false
the effect of the progesterone only pill is lost is more than 3 hours late
true
when is the maximum effect of the progesterone only pill?
48hours after digestion
what are the problems with IM injection of the progesterone only contraception?
> delay in fertility return
reversible bone density reduction
problem bleeding
weight gain
what is the action of IM injection of the progesterone only contraception?
> prevents ovulation
alters cervical mucous so it is hostile to sperm
renders endometrium unsuitable stopping implantation
a 150mg dose of progesterone only contraception is given IM, how long does it cover?
12 weeks
what is the action of the progesterone only subdermal implant?
primary: inhibits ovulation
secondary: inhibits sperm entry tot he upper repro tract
what two inter-uterine options are there?
> copper coil
> progesterone
what is the action of the copper coil?
copper is toxic
what is the action of the progesterone IUD?
thins the endometrial lining
what emergency contraception options are there?
> copper IUD (most effective)
levonorgestrel
ellaone
how long after unprotected sex is levonorgestrel affective for?
72hrs
how long after unprotected sex is ellaone affective for?
120 hrs
after how many weeks does a pregnancy termination need to be referred to England?
20 weeks
what complications can occur in a medical termination of pregnancy?
> prolonged bleeding
failure (<5 in 100)
haemorrhage (<5 in 100)
infection
what is the action of a medical termination of pregnancy?
mifepristone switches off pregnancy hormone which keeps the uterus from contracting
48hrs later misoprostol initiates uterine contraception opening the cervix and expelling the pregnancy
describe female sterilisation
laparoscopic traditional tube ligation
describe male sterilisation
permanent division of the vas deferens
what can the side effects of male sterilisation be?
> pain due to sperm granuloma
> irreversible
