Contraception Flashcards
Details about reproductive hormones and contraceptive methods available for use
What is meant by the follicular and luteal phases?
Follicular - days 1 - 14 when there is growth and development of the follicle within the ovary (leading follicle becomes prominent) Luteal phase - days 14-28 when the ovum is released from the mature follicle (ovulation) and there is development of the corpus luteum from the empty follicle.
When will menses occur?
after day 28 if there has been no fertilisation of the ovum. The corpus luteum will degrade (no more progesterone) and endometrial lining will be shed
Describe the pattern of LH and FSH through the follicular and luteal phases?
FSH levels are higher during the follicular phase There is a peak in both but LH will surpass FSH at ovulation (day 14) Levels will both decrease but FSH slightly higher during the luteal phase.
What happens to oestradiol during ovulation?
During the follicular phase there is a steady increase in levels, a sharp fall at ovulation then occurs followed by a gradual increase and decrease back to baseline during the luteal phase. Gradually increases through menses.
What happens to Progesterone during ovulation
Will remain at baseline throughout the follicular phase and ovulation. Will then increase significantly during the luteal phase (due to corpus luteum) and decrease again if no pregnancy and menses begins.
Why is there a peak in oestradiol prior to ovulation?
This will stimulate the release of LH and FSH and thus cause ovum release from follicle.
Give some examples of natural contraceptive methods?
Basal body temperature (if taken in morning there will be an increase in temp 0.2 degrees 3 days before and 6 days after ovulation) Cervical mucous will become sticky and thick post ovulation Breast feeding Lower and closed cervix when less fertile
How long can sperm and ovum live in the genital tract for?
Sperm = 5 days Ovum = 17-24hrs
What are the conditions for breast feeding to be 98% effective as a contraceptive?
Must be exclusively breast feeding Must be <6 months post-partum Must be amenorrhagic
How does the combined oral contraceptive pill work?
Releases oestrogen and progesterone to inhibit ovulation and trick the body into thinking you’re pregnant when you’re not (rigevidon or co-cyprodiol)
What is the failure rate of the COCP?
0.2% but in practice probably more like 9% as poor compliance and not taken as should
When should the COCP NOT be prescribed?
FHx or risk of VTE, stroke, clotting disorders etc > 35 yrs old with risk factors Migraine with aura (as will increase risk of stroke) Breast cancer hx or cervical cancer hx Within 6 weeks post-partum as increased VTE risk
What is the effect of oestrogen on clotting?
Will block anti-thrombin 3 and protein s (inhibit anti-coagulation)
What can the COCP help with?
Functional ovarian cysts, PCOS, premenstual syndrome, acne
Which cancers does COCP reduce risk of?
Endometrial and ovarian
