Contraception Flashcards
- List the common methods of contraception and describe the mechanism of action of each
- Describe the side-effects associated with the common methods of contraception
- Describe the methods of male and female sterilisation along with their indications and failure rates
- To be aware of the issues involved during counselling of a couple prior to sterilisation
- Describe the Abortion Act + the common medical and surgical methods of termination of pregnancy
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List the 3 combined hormonal methods of contraception (all contain ethinyl estradiol (EE) and synthetic progesterone (progestogen)); just in different forms of use)
Combined pill
Patch
Vaginal ring
List the 4 progestogen only methods of contraception
Progestogen-only pill (mini pill)
Implant
Injection
IUS (intra-uterine system)
Name the long term non-hormonal contraceptive that females use
Copper IUD
Mechanism of action of combined hormonal contraceptives (ethinyl estradiol (EE) and synthetic progesterone (progestogen))
Stop ovulation (due to the negative feedback effect of the oestrogen and progesterone) AND thicken cervical mucus on the cervix to slow the sperm
Non-contraceptive benefits of combined hormonal contraceptives
Regulate/reduce bleeding
Reduces functional ovarian cysts and risk of ovarian or endometrial cancer
Improve acne/hirsutism (excessive hair growth)
Side effects of combined hormonal contraceptives (pill/patch/ring)
Breast tenderness
Nausea
Headache
Irregular bleeding first 3 months
Serious risks with use of combined hormonal contraceptives (pill/patch/ring)
Increased risk of
- DVT
- arterial thrombosis –> MI/stroke
- cervical/breast cancer
Contra-indications of combined hormonal contraceptives
BMI >35
Breast feeding
Smoking >35
Hypertension
History of or family history of venous thromboembolisms
Prolonged immobility due to surgery or disability
History of migraines with aura
Mechanism of action of progestogen-only contraceptives (pill/implant/injection/IUS)
Inhibit ovulation AND thicken cervical mucus to prevent passage of sperm
Side effects of progestogen-only contraceptives (pill/implant/injection/IUS)
Irregular cycles Appetite increase Hair loss/gain Mood change Headache Acne
Contra-indications of progestogen-only contraceptives (pill/implant/injection/IUS)
Current or past history of breast cancer
Liver cirrhosis or tumours
Disadvantages of injectable progestogen
Not rapidly reversible – can take up to a year to return to normal fertility
Loss of bone mineral density with long term use
Increase in body weight, up to 2-3kg over a year
Altered bleeding patterns
(the only contraceptive with a causal effect on weight gain, delayed return of fertility and bone density)
Which progestogen only method has the best success rates
Implant
What non-hormonal contraceptives are there (4)
Male condoms
Female condoms
Diaphragm
IUD