Contraception Flashcards
What are the contraception methods that require ongoing action?
→ Oral contraception → barrier methods → Fertility awareness → Coitus interruptus → Oral emergency contraception
What are the methods which prevent contraception by default?
→ IUD/IUI/IUS
→ Progestogen implants
→ progestogen injections
→ Sterilisation
What are the risks of treatment?
→ Cardiovascular → Neoplastic → emotional → infection → allergy → iatrogenic
What are the risks of no treatment ?
→ childbirth related
→ abortion related
→ Social and economic costs
What is the latest progestogen?
→ Drospirenone
What do estrogens act on?
→ Anterior pituitary and hypothalamus
→ directly on the ovary
→ on the endometrium
Where do progestogens act on?
→ Anterior pituitary and hypothalamus → Directly on the ovary → On the endometrium → Fallopian tubes → cervical mucus
How does the combined oral contraceptive work?
→ Supraphysiological levels of progestogens and estrogens are given because this creates negative feedback
→ gnRH is not produced so FSH and LH are not produced
→ no follicle development and no ovulation
What happens if only estrogen is given?
→ Endometrium keeps proliferating
Why is progesterone added to the COCP?
→ Endometrium becomes thin
→ Implantation would not occur
→ Fimbriae become very inactive and delays gamete transport
What are the benefits of combined oral contraception?
→ reliable
→ Safe
→ Unrelated to coitus
→ rapidly reversible
What cancers does the COCP prevent?
→ 1/2 risk of ovarian cancer
→ 1/2 risk of endometrial cancer
What conditions does the COCP help?
→ endometriosis
→ Menorrhagia
→ dysmenorrhoea
What are the cardiovascular risks of the COCP?
→ Arterial - HBP, smoking
→ Venous - DVT, PE, migraine
What are the neoplastic risks of the COCP?
→ breast
→ cervix
→ liver
What are the 3 gastrointestinal risks of COCP?
→ COH/insulin metabolism
→ Weight gain
→ Crohns
What are the 3 hepatic risks of COCP?
→ Hormone metabolisms
→ Congenital nonhemolytic jaundice
→ Gallstones
What are the 3 dermatological risks of COCP?
→ Chloasma
→ Acne
→ erythema multiforme
What are the 3 psychological changes that COCP can have?
→ Mood swings
→ Depression
→ Libido
How do you take the COCP?
→1st packet the 1st day of period
→ 21 pills and stop for a 7 day break
→ restart each new packet on the 8th day
→ if missed pills then no pill free interval
What medications can interact with the COCP?
→ liver enzyme inducing drugs
→ Rifampicin and anti-epileptics
→ Broad spectrum antibiotics
What are the 2 progestogen only implants?
→ Nexplanon
→ Norplant