Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproductive System > Contraception > Flashcards

Contraception Flashcards

1
Q

How popular are different methods of contraception in those aged 16-49?

A 
From most to least commonly used:
Sterilised male or female
Combined hormonal contraception (CHC)
Intrauterine methods (coil)
Progestogen-only pill (POP)
Progestogen-only implants or injectable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What percentage of women are sexually active and not planning pregnancy but are not on any contraception?

A

12%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is contraceptive effectiveness measured?

A

Using the Pearl index

Defined as the number of contraceptive failures per 100 women-years of exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does the term “method failure” mean?

A

The occurrence of pregnancy despite the correct use of the method by the user

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does the term “user failure” mean?

A

Refers to the occurrence of pregnancy because the method is not used correctly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is LARC?

A

Long-acting reversible contraception (LARC) minimises user input and so minimises user failure rates.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When does ovulation occur?

A

Days 12-18 of a woman’s cycle if they are not on hormonal contraception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When is fertilisation most likely?

A

From sex on days 8-19 of a woman’s cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the component parts of combined hormonal contraception?

A
  • Pill- taken anytime daily, not good if frequent GI upset
  • Patch- EVRA, changed weekly, <5% have skin reaction
  • Ring- Nuvaring, changed every 3 weeks, can be taken out for 3/24hrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What hormones are given in combined hormonal contraception?

A

Ethinyl estradiol

Synthetic progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the combined effects of ethinyl estradiol and synthetic progesterone?

A

These two hormones work together to stop ovulation but also have an affect on cervical mucus and the endometrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do standard regimes of combined hormonal contraception involve?

A

21 days of treatment with a hormone-free week but tailored regimes can be used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why might a tailored regime for combined hormonal contraception be required?

A

To avoid withdrawal bleeds, and forgetting to restart after break

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the non-contraceptive benefits of combined hormonal contraception?

A
  • Regulate/reduce bleeding- help heavy or painful natural periods
  • Stop ovulation- may help premenstrual syndrome
  • Reduction in functional ovarian cysts
  • 50% reduction in ovarian and endometrial cancer
  • Improve acne / hirsutism
  • Reduction in benign breast disease, rheumatoid arthritis, colon cancer and osteoporosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the possible side effects of combined hormonal contraception?

A
  • Breast tenderness
  • Nausea
  • Headache
  • Irregular bleeding for first three months
  • Mood (link not 100%)
  • No link to weight gain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What serious risks are associated withcombined hormonal contraception?

A
  • Increased risk of venous thromboembolism
  • Increased risk of arterial thrombosis/MI/stroke
  • Increased risk of cervical cancer
  • Increased risk of breast cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the characteristics of the progesterone only pill?

A

Needs to be taken at the same time every day
No pill free window
Not a good choice if the patient has frequent GI upset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the characteristics of the desogestrel pill?

A

12 hour window period
Almost all cycle anovulant
Affects mucus
Bleed free

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the characteristics of the LNG NET pills?

A 
Three hour window period
1/3 anovulant
1/3 bleed free
1/3 irregular bleeding
1/3 regular period
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the contraindications of progesterone only methods?

A

Personal history of breast cancer or liver tumour

21
Q

What are the most common progestogenic side effects?

A
  • Appetite increase
  • Hair loss/gain
  • Mood change
  • Bloating or fluid retention
  • Headache
  • Acne
22
Q

What are the characteristics of injectable progesterone?

A

Aqueous solution of depopprovera
Requires IM injection into buttock every 12 weeks
Prevents ovulation
Alters cervical mucus
Makes endometrium unsuitable for implantation
Causes 70% of women to be amenorrhoeic after three doses
Oestrogen-free so few side effects

23
Q

What are the downsides of injectable progesterone?

A 
Delay in return to fertility of ~9 months
Can cause a reversible decrease in bone density
Bleeding common (especially after first two doses)
Weight gain (average 2-3kg).
24
Q

What are the characteristics of “the rod”?

A

Subdermal progestogen implant
Inhibits ovulation
Affects mucus
Can last up to three years (can be removed at any point)
No user input required
No causal effect on weight gain
30% have prolonged or frequent bleeding
May cause more serious mood change effects than other progestogen only methods

25
Q

What are the benefits of the coil?

A
  • Little user input after fitting- neither woman or partner should be aware of device
  • Can be fitted for any age and any parity
  • Effects and side effects immediately reversible when removed
26
Q

What are the downsides of the coil?

A
  • Very small infection risk in first 3 weeks (Offer STI testing to all with new partner or age under 25)
  • Risk of perforation during fitting
  • 5:100 risk expulsion- check threads after each period
  • If conceives may be ectopic (1 in 10 of pregnancies with coil)- but method is so effective that ectopic risk lower than for condoms
27
Q

What are the characteristics of a copper IUD?

A

Hormone free
Can last 5-10 years
Can make periods heavier and cramps more severe

28
Q

What are the characterisrics of the levonorgestrel IUS?

A

Affects cervical mucus and endometrium
Most still ovulate
Irregular bleeding initially but resolved after 4 months
Causes lower circulating levels of progesterone than other methods

29
Q

What are the possible methods of emergency contraception?

A
  • Copper IUD (most effective method), fit within 120 hours of unprotected sexual intercourse (UPSI) at any time of the cycle or by day 19 of a 28 day cycle
  • Levonelle- levonorgestrel pill taken within 72 hours, slightly less effective than IUD
  • Ellaone- ulipristal pill, take within 120 hours, less effective than IUD but more so than levonelle, however there are a few contraindications (breast feeding, enzyme reducing/acid reducing drugs)
30
Q

When in the cycle is cover provided from when starting contraception?

A

If contraception is started within the first 5 days of a cycle then cover is provided immediately. If it is started at other times however, need to use condoms or abstain for the next 7 days and then do a pregnancy test after 4 weeks

31
Q

When is it possible to get pregnant again following delivery, an abortion or miscarriage?

A

Delivery- 21 days

Abortion or miscarriage- 5 days

32
Q

When is breast feeding contraceptive?

A

First 6 months if feeding occurs every 4 hours and the woman is amenorrhoeic

33
Q

What contraceptive methods can breast-feeding women use?

A

Any

34
Q

What are the pros and cons of barrier methods?

A 
Pros:
-Only contraceptive to protect against STIs
Cons:
-Can break
-High user input
35
Q

What are the effects of female sterilisation?

A
  • Risks of GA and laparoscopy
  • Irreversible- risk regret
  • Failure rate 1 in 200 lifetime risk – could be ectopic
  • No effect on periods / hormones
  • Reduces ovarian cancer risk
36
Q

How long does it take for a vasectomy to be effective?

A

4-5 months

37
Q

How can the effectiveness of a vasectomy be checked?

A

Testing two sperm samples
Failure to get two clear samples is ~2:100
Lifetime failure rate of vasectomy after two clear samples have been obtained is 1:2000

38
Q

What are the cons of a vasectomy?

A

Irreversible
Risk of chronic testicular pain (<1:100)
NO effect on testosterone or sexual function
NO increased risk of cancer

39
Q

In what population are abortions most common?

A

20-24
Link to deprivation
90% of abortions in Scotland done under 12 weeks

40
Q

What steps are taken in a termination of pregnancy clinic consultation?

A
  • Scan for gestation and viability
  • Medical history- risk VTE/bleeding/ from GA/ contraceptive eligibility
  • Circumstances – reasons for considering abortion- see alone, language line, check no coercion or gender-based violence
  • Discuss methods of abortion
  • What to expect and when to seek medical advice
  • Contraception for afterwards
  • FBC/Rhesus Group
  • Vaginal swab for Chlamydia and gonorrhoea
  • STI bloods offered
41
Q

When can a surgical termination of pregnancy be offered?

A

5-12 weeks

42
Q

What are the risks of a surgical termination of pregnancy?

A

Slight risk of perforation and cervical injury,

Risks of infection and adverse effects of general anaesthetic

43
Q

When can a medical termination of pregnancy be offered?

A

5-24 weeks

44
Q

How is a medical termination of pregnancy administered?

A

A mifepristone oral antiprogestogen tablet needs to be taken, followed 36-48 hours later with misoprostol (initiates uterine contraction and expels pregnancy)

45
Q

How long does it take to pass a pregnancy under 12 weeks in a medical termination of pregnancy?

A

4-6 hours

46
Q

What are the possible complications of a medical termination of pregnancy?

A

Failure (1:100 <8 weeks, 8:100 >12 weeks)
Infection
Blood loss

47
Q

When can a home abortion be offered?

A

When the pregnancy is less than ten weeks

48
Q

What are the contraindications of combined hormonal contraception?

A 
BMI >35
Previous VTE
1st degree relative had VTE <45
Smokers >35
Previous arterial thrombosis
Focal migraine
Age >50
BP >140/90
BRCA +ve
Active gall bladder 
Previous liver tumour

Reproductive System (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions