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WEEK 2 SEM 4 > Contraception > Flashcards

Contraception Flashcards

1
Q

Why is it called combined oral contraceptive pill?

A

contains oestrogen and progestogen (acts like progesterone but it isnt)

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2
Q

What is the progestogen in the OCP called?

A

drospirenone (derived from spironolactone)

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3
Q

What is the mechanism of OCP?

A

more than normal oestrogen and progesterone is given
cause negative feedback
LH and FSH lower (switch off)
so no dominant follicle chosen and no ovulation

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4
Q

What does oestrogen act on?

A

anterior pituitary and hypothalamus
ovary
endometrium= proliferation

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5
Q

Why do we give progesterone with oestrogen?

A

bc oestrogen makes the endometrium proliferate and can lead to heavy bleeding during menstruation
so progesterone regulates this

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6
Q

Where do progestogens act?

A 
anterior pituitary and hypothalamus
ovary
endometrium= thins the endometrium
fallopian tubes
cervical mucus
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7
Q

What does progesterone do to the cervial mucus?

A

thickens it- stops sperm from getting in

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8
Q

What are the benefits of OCP?

A

RELIABLE
safe
nothing to do with sex
woman is in control

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9
Q

Are there non-contraceptive benefits of OCP? What are they?

A

give to people with heavy painful period- bc it thins endometrium
halve risk of ovarian cancer- bc no ovulation
less endometrical cancer risk- bc no proliferation
help with:
endometriosis
fibroids
rheumatoid arthritis
premenstrual syndrome
dysmenorrhoea
menorrhagia (irregular and excess bleeding)

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10
Q

What cardiovascular problems can progestogens cause as a result of the OCP?

A

Affect arterial side of heart

cause hypertension

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11
Q

What cardiovascular problems can oestrogen cause as a result of OCP?

A

venous problems= DVT, PE

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12
Q

What problems can the OCP cause?

A

acne
upset glucose control
mood swings
less libido

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13
Q

How is the OCP meant to be taken?

A

start pack on first day of period
take 1 pill everyday for 21 days
stop for 7 days (pill free interval)
take pill again on 8th day

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14
Q

Which pills shouldn’t be missed?

A

the ones at the end and start of the pack

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15
Q

What happens if you miss a pill?

A

if you miss a pill in the last week of the pack (befoe the pill free interval) dont take 7 days off- START THE NEXT PACK STRAIGHT AWAY

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16
Q

Which medications interact with the pill?

A
  1. cytochrome p450 complex in the liver will metabolize the oestrogen very quickly, could lead to pregnancy
  2. beware of rifampicin and anti-epileptics as they induce liver enzymes
  3. broad spectrum antibiotics
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17
Q

What is the combined vaginal contraceptive?

A

basically same as OCP
ring insert into vagina
release oestrogen and progesterone

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18
Q

How does the combined vaginal contraceptive work?

A

keep in for 21 days

remove for 7 days

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19
Q

What is an advantage for combined vaginal contraceptive?

A

dont have to take everyday

this could be disadvantage too lol

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20
Q

What is the main progestogen only method called?

A

Nexplanon

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21
Q

How do you apply nexplanon?

A

put in forearm (implant)
use local anaesthetic when putting in
lasts for 3 years
can easily take out

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22
Q

What are the different methods of progestogen only contraceptives?

A 
in arm (nexplanon, IMPLANON, NORPLANT)
intrauterine devices (coils)
pills (cerazette)
injections (weekly)
Hormone releasing IUCD= sit in uterus and release progestogens into uterus- thin the endometrium- stop uterine tubes working- COMMON EXAMPLE IS MIRENA IUS
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23
Q

How does cerazette work?

A

pill

take everyday

24
Q

What effect can oestrogen have on milk?

A

dries babies milk thats why only progesterone method is good

25
Q

What is a progestogen only contraceptive injection?

A

depo provera

12 weekly injection

26
Q

What is an intrauterine device made of?

A

copper

27
Q

How long does an intrauterine device last?

A

insert in uterus

works for 5-20 years

28
Q

What is the mechanism of an intrauterine device?

A

copper- spermicidal (kills sperm)
bc of foreign body there is low chronic endometritis- this inflammation and prostaglandin secretion stops implantation occuring

29
Q

What is progesterone bearing IUD?

A

only lasts 5 years bc the hormone runs out

30
Q

What are the benefits of the IUD?

A 
not user dependent
immediately work
can reverse straight away
long term use
unrelated to sex
free from serious medical dangers
31
Q

What are the disadvantages of IUD?

A

medically fitted
can be painful when inserting
no infection protection
there are strings so the male might feel it during intercourse

32
Q

What are the risks of IUD?

A

can perforate uterus
if pregnant can lead to miscarriage
can be expelled if not insert right
ectopic preggo

33
Q

When can you not insert an IUD?

A

pelvic inflammatory disease
chance of getting pregnant
unexplained vaginal bleeding
uterine cavity abnormalities

34
Q

What is a uterine fibroid?

A

swelling of the uterine muscle

35
Q

What are male condom advantages?

A

man in control
protect against STIs
easily available

36
Q

What are female condom advantages?

A

women in control
protect against STIs
not dependent on male erection to work

37
Q

What are disadvantages of male condoms?

A

last minute use
need to be taught
can have allergies to latex
high failure rate- can break

38
Q

What are disadvantages of female condoms?

A

obtrusive = are large
expensive
rustle during sex
uncertain failure rate

39
Q

What are the 2 types of caps?

A

diaphragm and suction

40
Q

Explain diaphragm:

A

older people use this most often
should not be used as it is the least successful contraceptive
they are made of latex
they fit across the vagina
can with spermicide and left in at least 6 hours after sexual intercourse-the spermicide may be inserted up to 6 hours before sexual intercourse

41
Q

What are the advantages of diaphragm?

A

woman in control
can put 6 hours in advance
protection against cervical dysplasia

42
Q

What are the disadvantages of the diaphragm?

A

taught how to use
highest failure rate
increase UTI chance

43
Q

How can you predict ovulation?

A

increase in temperature near ovulation time

LH surge in urine test

44
Q

What is the use of emergency contraception?

A

after unprotected sex

can use pill up to 72 hours after sex

45
Q

What are the different emergency contraceptions?

A

levonelle
ellaOne
scherine PC4
copper coil

46
Q

What is levonelle?

A

high dose progesterone

Levonelle 2 consists of two 2 tablets each containing 750micrograms of Levonorgestrel.

  • Low failure rate in the first 24hrs
  • Very little nausea
  • Only contraindicated in women taking very potent liver enzyme medication (e.g. anti-TB)
47
Q

What is ellaOne?

A

similar to levonelle

selective progesterone receptor modulator

48
Q

What is Scherine PC4?

A

combined OCP

49
Q

What is the rule when using levonelle?

A

have as soooooon as you can after sex

can work up to 72 hours after sex though

50
Q

What is the rule when using ellaOne?

A

workes up to 120 hours after sex

51
Q

What is the mechanism for combined oral contraceptive pill and levonelle?

A

give high progesterone in first half of cycle = postpones ovulation
in the second half of the cycle= implantation is stopped so having sex in first half or 2nd half of cycle doesnt allow implantation

52
Q

What is the mechanism for copper IUD?

A

100% success rate
prevents implantation in 2nd half of cycle
bc chronic inflammation prevents implantation

53
Q

What do all COCPs have?

A

ethinyloestradiol

54
Q

Why is drospirenone used?

A

reduces bloating felt with other contraceptives

55
Q

What are advantages of suction caps?

A

Suction caps advantages
 A suitable method for women with poor pelvic floor muscles
 There are no problems with regards to causing rubber allergies
 Regarded as being a very unobtrusive method
 Puts the woman in control

56
Q

What are disadvantages of suction caps?

A

Suction caps disadvantages
 Requires an accessible and suitable cervix
 Higher failure rate than diaphragm
 Not easy to find an experienced teacher

57
Q

What are the advantages and disadvantages of fertility awareness?

A

 Is a non-medial method
 Can be used in developing countries where other methods are not available
 The catholic church allows this method
 This method can result in closeness of understanding between partners (enhance relationship)

 Failure rate is heavily user dependent (i.e. you have to do it properly)
 Requires skilled teaching
 May require co-operation between partners which causes problems
 Can limit sexual activity
 Can cause strain on relationship

WEEK 2 SEM 4 (6 decks)

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