Contraception Flashcards
What are methods of contraception?
Barrier - condom, caps, female condom, spermicide, diaphragms Natural methods - fertility awareness COCP POP Progesterone implant Progesterone depot Intrauterine device - Copper coil Intrauterine system - progesterone releasing coil - Mirena Tubal ligation Vasectomy Emergency
How does the condom work?
Physical barrier
Use new condom with each episode of intercourse
Do not use oil based lubricant
Helps protect against STIs
How do diaphragms work?
Stretch from pubic bone to posterior fornix
Check after insertion that the cervix is covered
Insert <2h before intercourse
Use with a spermicide
Problems
UTIs
Rubber sensitivty
What is a spermicide
Nonoxinol - 9
Unreliable unless used with a barrier
What is fertility awareness?
Physiological monitoring to find fertile times (6 days prior to ovulation - life of sperm) to 2 days afterwards (life of ovum)
Cervical mucus becomes clear and slippery prior to ovulation then abruptly thicker and tacky
No intercourse from day mucus become slippery to 3d after it becomes tacky
Successful if regular cycles and self control
What are high tech natural methods?
Urine test sticks to measure LH for LH surge
Database build of woman’s natural variability over time
How does COCP work? Risks?
Inhibits ovulation
Increased risk of VTE, breast cancer and cervical cancer
How does POP work? SE?
Thickens cervical mucus
Irregular bleeding
How does depot injectable contraception work? Name? Duration?
Medroxyprogesterone acetate
Inhbits ovulation
Thickens cervical mucus
Lasts 12 weeks
How do implantable contraceptives work? Name? Duration? SE?
Etonogestrel
Inihibits ovulation
thickens cervical mucus
3 years
Irregular bleeding
How does intrauterine contraceptive device work?
Copper coil
Decreases sperm motility and survival
how does intrauterine system work?
Levonogestrel
Prevents endometrial proliferation
Thickens cervical mucus
Irregular bleeding
What are the fraser guidelines
Guidance on when <16 year olds may be prescribed contraception without parental consent
What are Fraser guidelines?
They understand doctors advice
young person cannot be persuaded to inform parents they are seeking contraceptive advice
They are likely to begin or continue intercourse with or without contraceptive treatment
Unless they receive contraceptive treatment, their physical or mental health is likely to suffer
Young person’s best interest require that the doctor gives advice and/or treatment without parental consent
What is Gillick competence?
Broader
Relates to children < 16 who have legal capacity to consent to medical examination and treatment
