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Contraception Flashcards

1
Q

Which types of contraception act in the ovaries?

A

Combined hormonal contraception
Progesterone-only pill
Injection
Implant

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2
Q

Which types of contraception act in the endometrium?

A

IUS and IUD

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3
Q

Which types of contraception act in the cervix?

A

IUS
Progesterone-only pill
CHC

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4
Q

Describe the female menstrual cycle

A

FSH
Ovarian follicular development
Oestrogen levels rise

Oestrogen
Endometrial proliferation
LH surge

LH
Ovulation
Corpus luteum formation
Oestrogen and progesterone rise

Progesterone
Endometrial thickening

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5
Q

What is the mode of action for the combined hormonal contraception?

A
  • Inhibits LH and FSH which prevents ovulation
  • Thickens cervical mucus which is a natural sperm barrier
  • Thins endometrium which prevents implantation
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6
Q

What is the failure rate for Combined hormonal therapy?

A

If used perfectly 0.3 per 100 woman years

If used typically 9 per 100 woman years

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7
Q

What are the different ways CHC can be administered?

A

Birth control pills
Patch
vaginal ring

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8
Q

What are the advantages and disadvantages of the combined hormonal contraception?

A

Advantages

  • Reduces PMS
  • Reduces heavy menstral bleeding
  • Reduces painful periods
  • Reduces the risk of pelvic inflammatory disease
  • Reduces the risk of ovarian and colorectal cancer
  • improves acne
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9
Q

What are the disadvantages of combined hormonal therapy?

A
  • High risk of venous thromboembolism
  • High risk of stroke
  • High risk of cardiovascular;ar disease
  • Increased risk of breast cancer- (returns to normal after 10 years)
  • causes depression

Temporary side effects:
headache, nausea, breast tenderness,mood changes, breakthrough bleeding.

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10
Q

Conditions which you should not take CHC with?

A
  • cardiovascular disease (atrial fibrillation)
  • Stroke
    -Hypertension
  • Liver disease
    -BMI>35
    -smoker over 35
    < 6 weeks postpartum if breastfeeding
    <3 weeks postpartum if non-breastfeeding
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11
Q

What is the mode of action for progesterone only contraception?

A

Thickens cervical mucus- natural sperm barrier
Thins endometrium- prevents implantation
Inhibits ovulation

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12
Q

What is the failure rate for progesterone only contraception?

A

If used perfectly 0.3 per 100 woman years

If used typically 9 per 100 woman years

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13
Q

What are the different types of progesterone only contraception?

A

Injection (Depo-Provera)
lasts 3 months

Implant (Nexplanon/Implanon)
lasts 3 years

Intrauterine system (IUS)
lasts 5 years
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14
Q

What are the advantages of progesterone only contraception?

A
  • Reduces menstrual bleeding
  • Reduces painful periods
  • Reduce risk of endometrial cancer
  • Can be used when breastfeeding
  • Fewer adverse effects compared to CHC
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15
Q

What are the disadvantages of progesterone only contraception?

A
  • Irregular spotting
  • Acne
  • Headaches, nausea, mood swings, bloating, breast tenderness, weight gain
  • Ovarian cysts
  • All above usually settle after 6 months

IUS only – expulsion, ectopic pregnancy

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16
Q

Conditions which you should not take progesterone only contraception with?

A

Unexplained vaginal bleeding
If VTE / stroke / Ischaemic heart disease occurs during use
Breast cancer
Severe liver disease
IUS only – Pelvic inflammatory disease, >48h - <4w postpartum

17
Q

What is the mode of action for the Intrauterine device/Copper coil?

A

Copper is spermicidal

Thickens cervical mucus-natural sperm barrier

May act as physical barrier to implantation

18
Q

What is the failure rate for Intrauterine device/Copper coil?

A

0.6-0.8 per 100 woman years

19
Q

What are the advantages of the Intrauterine device/Copper coil?

A

Long-acting (5-10 years)

No hormones

20
Q

What are the disadvantages of the Intrauterine device/Copper coil?

A 
Uterine perforation
Expulsion
Ectopic pregnancy
Pelvic inflammatory disease
Menorrhagia (IUD only)
21
Q

Conditions which you should not take Intrauterine device/Copper coil with?

A

Unexplained vaginal bleeding
PID / untreated STI
Cancers (cervical, endometrial)

22
Q

List the two types of barrier methods, what is there failure rate?

A

Male condom
If used perfectly failure rate 2 per 100 woman years
If used typically failure rate 18 per 100 woman years

Diaphragm / cap
If used perfectly, failure rate 6 per 100 woman years
If used typically, failure rate 12 per 100 woman years

23
Q

What has to be monitored in the natural planning method?

A

Temperature
Consistency of cervical mucus
Position of cervix
Day of cycle

24
Q

What is the failure rate for the natural planning method?

A

If used perfectly failure rate is 0.5 per 100 woman years

If used typically failure rate is 24 per 100 woman years

25
Q

What are the advantages of the natural family planning method?

A

Does not involve using any chemicals or physical devices
No physical side effects
Can help person to recognise normal and abnormal vaginal secretions
Acceptable to all faiths and cultures

26
Q

What are the disadvantages of the natural family planning method?

A

Takes 3-6 menstrual cycles to learn effectively

Have to keep daily records

Some events - e.g. illness, lifestyle, stress, travel – may make fertility indicators harder to interpret

Need to avoid sex or use barrier methods during fertile time

Does not protect against STIs

27
Q

What is the withdraw method? What is the failure rate?

A

Male partner pulls penis out of vagina before he ejaculates so that sperm cannot reach uterus

Failure rate- With typical use, rate is 22 per 100 woman years

28
Q

What does female sterilisation involve?

What is the failure rate?

A

Laparoscopic bilateral tubal occlusion with clips

Lifetime failure rate 1 in 200

29
Q

What does male sterilisation involve?

What is the failure rate?

A

bilateral ligation of vas deferens

Lifetime failure rate 1 in 2000

30
Q

State 3 risks for sterilisation in menand women?

A

Men- Pain
Swelling
Infection
regret

Women-
Pain
Heavier periods if <30 years
Ectopic pregnancy
regret
31
Q

What is the mode if action for emergency contraception?

A

Delay ovulation

32
Q

State the 2 types of emergency contraception, when they can be used and there success rate

A

Levonelle-single dose, up to 72 hours
Pregnancy rate 0.6 – 2.6%

EllaOne- single dose, up to 120 hours

Pregnancy rate 1 – 2%

33
Q

What is the mode of action for Emergency contraception - IUD?

A

Inhibits fertilisation by direct toxicity

Affects implantation by causing endometrial inflammation

34
Q

What is the failure rate for Emergency contraception - IUD, when can it be used?

A

<0.1%

up to 5 days after

Human development (8 decks)

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