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BS - Reproductive System > Contraception > Flashcards

Contraception Flashcards

1
Q

What is the definition of contraception?

A

The deliberate use of artificial methods or other techniques to prevent pregnancy as a consequence of sexual intercourse

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2
Q

What is meant by birth control?

A

Methods or devices used to prevent pregnancy

This is also known as contraception and fertility control

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3
Q

what is meant by family planning?

A

Planning, provision and use of birth control

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4
Q

What % of sexually active women have used birth control at some point in their life?

A

99%

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5
Q

How many women use the pill?

A

100 million

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6
Q

What is the UK MEC?

A

it helps clinicians decide what contraceptives they can safely recommend based on the medical conditions of patients in their care

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7
Q

What is meant by category 1 in UK MEC?

A

A condition for which there is no restriction for the use of the method

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8
Q

What is meant by category 2 in UK MEC?

A

A condition where the advantages of using the method generally outweigh the theoretical or proven risks

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9
Q

What is meant by category 3 in UK MEC?

A

A condition where the theoretical or proven risks usually outweigh the advantages of using the method

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10
Q

Under which conditions may a method be used in category 3 in UK MEC?

A

The provision of a method requires expert clinical judgement and a referral to a specialist contraceptive provider

This method is not recommended unless other more appropriate methods are not available/acceptable

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11
Q

What is meant by category 4 in UK MEC?

A

A condition which represents an unacceptable health risk if the method is used

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12
Q

what are the characteristics of an ideal contraceptive?

A
  1. 100% effective
  2. 100% convenient - independent of intercourse, nothing to remember
  3. 100% reversible
  4. 100% safe
  5. cheap
  6. independent of the medical profession
  7. acceptable to every religion and culture
  8. having non-contraceptive benefits - control of periods, reduction in cancer etc.
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13
Q

What are the most effective contraceptives, with less than 1 pregnancy per 100 women in a year?

A
  1. implant
  2. intrauterine device
  3. sterilisation - in both male and female
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14
Q

What type of contraceptives cause 6-12 pregnancies per 100 women in a year?

A
  1. injectable contraceptives
  2. pill
  3. patch
  4. ring
  5. diaphragm
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15
Q

What are the least effective types of contraceptives causing 18 or more pregnancies per 100 women in a year?

A
  1. male condom
  2. female condom
  3. withdrawal during sex
  4. sponge
  5. fertility-awareness based months
  6. spermicide
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16
Q

What is the mechanism of action of combined contraceptives?

A

They prevent ovulation by suppressing the release of gonadotrophins

They inhibit follicular development and prevent ovulation

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17
Q

What does progesterone negative feedback lead to?

A
  1. decreased pulse frequency of GnRH release by hypothalamus

2. this decreases the release of FSH and LH

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18
Q

What is the result of decreasing levels of FSH?

A

It inhibits follicular development

This prevents an increase in estradiol levels and a mid-cycle LH surge

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19
Q

What actually prevents ovulation when using a combined contraceptive?

A

Inhibition of follicular development and the absence of an LH surge

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20
Q

How do progesterone-containing contraceptives also help to prevent pregnancy?

A

They inhibit sperm penetration through the cervix into the upper genital tract

They decrease the amount and increase the viscosity of cervical mucus

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21
Q

What is the failure rate of the combined pill?

A

0.3 - 9%

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22
Q

What is contained within the combined pill?

How does it work?

A

It contains oestrogen and progesterone

It prevents ovulation by suppressing LH and FSH

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23
Q

How often is the combined pill taken?

A

It is taken 21 days out of 28

There is a pill-free week every month

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24
Q

Other than preventing ovulation, how does the combined pill work?

A

It thickens cervical mucous

It reduces endometrial receptivity

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25
Q

What are the contraindications of the combined pill?

A

Caution should be taken with smoking and obesity

Also hypertension

And a personal history of thrombosis or CHD

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26
Q

How does the Evra contraceptive patch work?

How often is it worn?

A

it works like the combined pill to prevent ovulation

It is worn 21 days out of 28

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27
Q

What is the failure rate of the Evra contraceptive patch?

A

0.3-9%

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28
Q

Where is the placement site of the Evra contraceptive patch?

A

The placement site should be rotated

29
Q

How does the Nuvaring combined ring work?

A

It works like the combined pill

The ring is worn for 3 weeks and discarded

A new ring is inserted 1 week later

30
Q

What is the failure rate of the Nuvaring combined ring?

Why do people choose this method?

A

0.3-9%

The ring is flexible and easy to insert and remove

31
Q

What does the vaginal contraceptive ring deliver whilst it is inserted into the vagina?

A

It delivers very low doses of ethinyl estradiol and etonogesterel

These sex hormones are delivered continuously whilst in the vagina

32
Q

How is the progesterone-only pill taken?

What is the failure rate?

A

One pill is taken each day with no pill-free week

The failure rate is 0.3-9%

33
Q

How does the progesterone only pill work?

A

it thickens cervical mucus

it reduces endometrial receptivity

it suppresses ovulation

34
Q

What are the negative consequences of taking the progesterone only pill?

A

it requires accurate pill taking within hours

irregular bleeding

35
Q

Which particular group of people are often advised to take the progesterone only pill?

A

Women over 35 and smokers

36
Q

What are examples of injectable progesterone only contraceptives?

What is the failure rate?

A

Depo Provera, Sayana Press, Noristerat

Failure rate 0.2-6%

37
Q

How do injectable progesterone only contraceptives work?

A

They prevent ovulation

They also thicken cervical mucus and reduce endometrial receptivity

38
Q

How often are progesterone only contraceptives injected?

A

Either intramuscular or subcutaneous

Every 8 or 12 weeks

39
Q

What are periods like when injecting progesterone only contraceptives?

A

There are no periods

But there may be irregular spotting

40
Q

What is Implanon and what is the failure rate?

A

It is a progesterone only implant under the skin

The failure rate is 0.05%

41
Q

How does Implanon work?

A
  1. prevents ovulation
  2. thickens cervical mucus
  3. reduces endometrial receptivity
42
Q

How often does Implanon last and what is the bleeding pattern like?

A

it lasts 3 years

It has an irregular bleeding pattern

43
Q

What is IUS?

A

Intrauterine system

It is a small T shaped plastic device that releases progesterone

44
Q

What is the failure rate of IUS?

How long does it last?

A

Failure rate is 0.2%

It lasts for 5 years

45
Q

How does IUS work?

A

It thickens cervical mucus

It leads to endometrial thickening

(It also suppresses ovulation)

46
Q

How does IUS affect periods?

A

It reduces periods and can stop them entirely

47
Q

What is IUD

A

Intrauterine device

It is a T-shaped plastic and copper device that releases copper

48
Q

How does IUD work?

A

The copper prevents fertilisation by having a direct effect on sperm

It also causes endometrial changes

49
Q

What is the failure rate of IUD?

How long does it last?

A

Failure rate is 0.6-0.8%

It lasts for 5-10 years

50
Q

How does IUD affect periods?

A

it can cause heavy periods

51
Q

What is the failure rate of condoms?

A

2-18%

There are both male and female condoms

52
Q

What is the benefit of using condoms?

A

they protect against STIs

53
Q

What is meant by “double dutch”?

A

Using both barrier contraception (e.g. condom) and an additional method

54
Q

How do caps and diaphragms work?

A

They are latex and are left in for 6 hours

They block the uterus

They are used with spermicide

55
Q

What is the failure rate of caps and diaphragms?

How do they affect contraction of STIs?

A

Failure rate is 6-12%

They have some protection against STIs

56
Q

What is the negative consequence of using a diaphragm?

A

there is an increased risk of urethritis

57
Q

What is the sterilisation method used for males?

A

Vasectomy

It involves cutting the ends of the vas deferens are sealing them

58
Q

What is the failure rate for vasectomy?

A

0.1 - 0.15%

2 consecutive negative samples are needed to prove effectiveness

59
Q

What is meant by late recanalisation after vasectomy?

A

The appearance of motile sperm after the vasectomy was declared a success

60
Q

What are the sterilisation techniques in females?

A

tubal occlusion

ligation

61
Q

What is tubal occlusion?

A

a micro-insert is placed into each of the fallopian tubes

this forms a natural barrier to prevent sperm reaching the egg

62
Q

What is tubal ligation?

A

This involves “getting your tubes tied”

Fallopian tubes can be banded, cauterised or tied and cut

63
Q

What is the failure rate for female sterilisation?

What is the risk of failure?

A

failure rate is 0.5%

Failures have a higher risk of ectopic pregnancy

64
Q

What are the 2 oral emergency contraceptives?

A

Ulipristal (take within 120 hours)

and Levonorgesterel (take within 72 hours)

65
Q

How do the oral emergency contraceptives work?

How effective are they?

A

They work by delaying ovulation

They are effective if taken promptly and are available without prescription

66
Q

What is the most effective emergency contraceptive?

A

The copper IUD

This is also suitable for ongoing contraception

67
Q

What is the main non-contraceptive benefit?

A

reduction in risk of endometrial and ovarian cancers by 40%

This is due to the endometrial effects and suppression of gonadotrophins

68
Q

What are the other non-contraceptive benefits?

A
  1. decrease benign breast disease - fibrocystic and fibroadenoma
  2. reduce iron-deficiency anaemia
  3. treats pelvic pain caused by endometriosis
69
Q

What are the risks of contraception?

A
  1. failure (this increases risk of ectopic pregnancy)
  2. inconvenience
  3. increased risk of clots, heart disease and stroke
  4. pain during operative sterilisation and indwelling devices

BS - Reproductive System (12 decks)

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