Contraception Flashcards
What would be the characteristics of the ideal contraceptive?
100% reversible 100% effective 100% unrelated to intercourse 100% free of adverse side effects 100% protective against STIs Non-contraceptive benefits Low maintenance
What is method failure of contraception?
Pregnancy despite being used correctly by the user
What is user failure of contraception?
Pregnancy because the method is used incorrectly by the user
When is the highest chance of pregnancy in the cycle?
Day 8-19
What is used in combined hormonal contraception?
Pill
Patch
Vaginal ring
What hormones are used by combined hormonal contraception?
Ethinyl estradiol and synthetic progesterone (Progestogen)
What is the effect of combined hormonal contraception?
Stops ovulation and affects cervical mucous and the endometrium
What is the regime with combined hormonal contraception?
21 days followed by a hormone free week
What is a contraindication of the pill in combined hormonal contraception?
If frequent GI upset
What is the name of the contraceptive patch?
EVRA patch
what is the name of the contraceptive ring?
Nuvaring
How often must the nuvaring be changed?
Every 3 weeks
What are non-contraceptive benefits of combined methods?
Reduce bleeding - helps with menorrhagia Stop ovulation Reduction in functional ovarian cysts 50% reduction in ovarian and endometrium cancer Improve acne/hirsutism
What are side effects of combined methods?
Breast tenderness Nausea Headache Irregular bleeding for the first 3 months Weight gain
What are serious risks associated with combined hormonal contraception use?
Increased venous thrombosis risk - DVT/PE
Increased risk of arterial thrombosis - MI/stroke
Avoid if active gall bladder disease or history of liver tumour
Increased risk of breast cancer
What is a contraindication for the progestogen only pill?
Frequent GI upset
What are side effects of taking the progestogen only pill?
Appetite increase Hair loss/gain Mood change Bloating or fluid retention Headache Acne
What is the action of injectable progestogen?
Prevents ovulation
Alters cervical mucus to make it hostile to sperm
Makes endometrium unsuitable for implantation
How often does injectable progestogen need to be administered?
1ml 150mg IM injection into the upper outer quadrant of the buttock every 13 weeks
What are toublesome side effects of injectable progestogen?
Can be around a 9 month delay in returning to fertility
Reversible reduction in bone density
Weight gain
Problematic bleeding, especially in first 2 doses
What is ‘The rod’?
A subdermal progestogen implant
What makes up the rod?
Core - 68mg etonogestrel
Membrane - Ethinyl vinyl acetate 0.6mm thick
What is the action of the rod?
Inhibits ovulation and effects cervical mucus
How long does the rod last?
Up to 3 years or earlier if the owner wants it removed
What are the 2 types of coil in intrauterine conception?
Copper
Levonorgestrel
How long can an intrauterine device be fitted for?
5-10 years
How does a copper intrauterine device work?
Copper is toxic to sperm, stops sperm reaching the egg and sometimes prevents implantation
What is the most effective option for emergency contraception?
Copper IUD
What are options for emergency contraception?
Copper IUD
Levonelle pill
Ellaone
How is female sterilisation normally done?
Laparoscopically, Filshie clips are applied across the tube to block the lumen
What are risks of female sterilisation?
General risks with general anaesthetic and laparoscopy
Irreversible procedure - may regret it
1 in 200 failure rate
How is a vasectomy done?
Vas deferens is divided and the ends are cauterised through a small incision on the midline of the scrotum
What is the most common age group to get an abortion?
20-24
Is a medical staff member allowed to refuse a women to have an abortion?
Legally they can refuse to perform it themselves however they must also ensure the woman is still able to access care
