Contraception Flashcards

1
Q

What is the pearl index?

A

The number of contraceptive failures per 100 women years of exposure from the initiation of the product to the end of the study

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2
Q

What is method failure with regards to contraception?

A

Pregnancy despite the correct use of method by the user

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3
Q

What is user failure with regard to contraception?

A

Pregnancy because the method was not used correctly by the user

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4
Q

Why does long acting reversible contraception minimise user failure rates?

A

It minimises user input and therefore minimises failure rate

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5
Q

On which days of the menstrual cycle are pregnancy most likely?

A

Days 8-19

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6
Q

Name the three types of combined hormonal contraception

A

Pill
Patch (EVRA)
Vaginal ring (Nuvaring)

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7
Q

Which hormones are in the combined hormonal contraception

A

Ethinyl estradiol and synthetic progesterone

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8
Q

How are the different types of combined hormone contraception taken and what are the contraindications?

A

Pill - taken daily (not good if frequent GI upset)
Patch - changed weekly (<5% skin reaction)
Ring - changed every 3 weeks

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9
Q

What are the non-contraceptive benefits of the combined hormone methods?

A
  • Regulates/reduces bleeding (helps heavy/painful bleeding)
  • Stops ovulation (helps premenstrual syndrome)
  • Reduction in functional ovarian cysts
  • 50% reduction in ovarian and endometrial cancer
  • Improves acne/hirsutism
  • Reduction in benign breast disease, rheumatoid arthritis, colon cancer and osteoporosis
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10
Q

What are the side effects of the combined hormone contraceptive?

A

Breast tenderness, nausea, headache, irregular bleeding in the 1st 3 months, mood changes and weight gain

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11
Q

What are the serious risks of combined hormonal contraception use?

A

Increased risk of venous thrombosis (DVT/PE), increased risk of arterial thrombosis (MI/ischaemic stroke), increased risk of cervical cancer and increased risk of breast cancer

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12
Q

What are the types of progesteron only (mini) pill and what are the contraindications?

A
  • Desogestrel: 2hr window
  • LNG NET: 3hr window (affect on periods varies)
  • Contraindications: personal history of breast or liver cancer
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13
Q

What are the side effects of progesterone only pills?

A

Appetite increase, hair loss/gain, mood change, bloating/fluid retention, headache and acne

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14
Q

How does the depo injection work?

A
  • IM injection into the buttocks every 13 weeks
  • Prevents ovulation, alters cervical mucus making it hostile to sperm and makes the endometrium unsuitable for implantation
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15
Q

What are the disadvantages to the depo injection

A

Delay in return to fertility, reversible reduction in bone density, problematic bleeding (esp. 1st 2 doses) and weight gain

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16
Q

How does the subdermal progestogen implant (rod) work?

A

Inhibition of ovulation and effects cervical mucus - works for up to 3yrs

17
Q

What are the disadvantages of the implant?

A

30% have prolonged, frequent bleeding and it can cause mood change

18
Q

How does the copper IUD work?

A
  • Toxic to sperm and may prevent implantation of the fertilised egg
  • Hormone free
19
Q

How does the levonorgestrel IUS work?

A
  • Affects cervical mucus and endometrium (most women still ovulate)
  • Stops fertilisation of egg
  • Slow release progestogen
20
Q

What are the options for emergency contraception?

A
  • Copper IUD (within 120hrs or by day 19)
  • Levonorgestrel/levonelle (within 72hrs)
  • Ulipristal/ellaone (within 120hrs)
21
Q

What are the contraindications of the ellaone pill?

A

Breast feeding, enzyme inducing drugs and acid reducing drugs

22
Q

What effect does pregnancy/ termination/ miscarriage/ breastfeeding have on the chances of becoming pregnant

A
  • Pregnancy: can become pregnant 21 days after pregnancy
  • Miscarriage/termination: can become pregnant 5 days after
  • Breast feeding: only contraceptive for six months, if feeding every four hours and only if amenorrhoeic
23
Q

Name the two medicines used for a medical termination of pregnancy

A

Mifepristone (antiprogestogen) and misoprostol (uterine contraction)