Contraception Flashcards
What are the only contraceptive options for males?
Condoms
Vasectomy - cut and tie the vas deferens
In relation to contraception, what is a method failure?
Pregnancy despite correct use of method by user
In relation to contraception, what is a user failure?
Pregnancy because the user hasn’t taken the contraception correctly
What types of contraception are Long-acting Reversible contraceptives (LARC)?
IUD
Implant
Normal menstrual cycle
28 days normally but this varies. If it is 21-40 but regular then this is a normal variant.
Ovulate 2 weeks before period (around days 12-18)
The egg survives for 24 hours
When is the highest chance of pregnancy during a female’s cycle?
Day 8-19
Which 2 hormones are in the combined hormonal contraception? And what do they do?
Ethinyl estradiol (an estrogen)
Synthetic Progesterone (a progestogen)
They stop ovulation, also affect cervical mucus and endometrium
What is the standard regime of the combined pill? i.e how do you take it?
Take the pill for 21 days with a 7 day break
What is tricycling?
There is the option to take 3 packs (so covering 3 cycles) of the pill before having a 7 day break - this helps if you have bad symptoms on your period or if you often forget to restart after a break
What different forms can combined hormonal contraception be taken in?
Pill
Patch - changed weekly
Vaginal ring - changed every 3 weeks
What are some benefits of combined hormonal contraception?
- Regulate or reduce periods - help with heavy or painful natural periods
- Stop ovulation - may help PMS
- 50% reduction in ovarian and endometrial cancer
- Reduction in functional ovarian cysts - helps PCOS symptoms
- Can improve acne
Negative side effects of combined hormonal contraception
Breast tenderness Nausea Headache Irregular bleeding first 3 months Mood? - hard to tell if it is the pill causing this Weight gain - not causal
What are some serious risks of combined hormonal contraception?
Increased risk of venous thrombosis (DVT or PE) and arterial thrombosis (MI or ischaemic stroke)
Increased risk of cervical and breast cancer - this goes back to normal after you come off the pill for over 10 years
What is the ‘mini pill’?
The progestogen-only pill. You take it at the same time every day without a pill-free interval (usually no bleeding). Prevents ovulation and affects cervical mucous. It is Oestrogen free so as a result there are very few contraindications.
There are 2 different types:
- 3-hour progestogen-only pill (traditional progestogen-only pill) – must be taken within 3 hours of the same time each day
- 12-hour progestogen-only pill (desogestrel progestogen-only pill) – must be taken within 12 hours of the same time each day
Side effects of the mini pill (progestogenic side effects)
These vary between women and are only troublesome not ‘dangerous’
Appetite increase Hair loss/gain Mood change Bloating or fluid retention Headache Acne
No increased risk of venous or arterial thrombosis
should be avoided if current breast cancer or liver tumour past/present
Injectable progestogen ‘the jag’
Progestogen only
Deep intramuscular injection into the upper outer quadrant of the buttock every 13 weeks
Prevents ovulation, alters cervical mucus making it hostile to sperm and makes endometrium unsuitable for implantation
Negatives surrounding the ‘jag’
Delay in return to fertility – average 9 months
Problematic bleeding especially first 2 doses
Bone density affected - although this is reversible
Weight gain - the injection is the only contraceptive that has causal effect on weight gain
Describe the rod/implant
Releases progestogen into your bloodstream
Lasts for 3 years
60% have no bleeding but 30% have prolonged frequent bleeding
May cause mood change more often than other progestogen only methods
Describe the coil/intrauterine device
Device inserted into womb.
2 different types - one releases copper - copper IUD and the other releases progestogen (IUS).
IUD - copper is toxic to sperm and the ovum. It also alters the endometrium and makes it less accepting of implantation.
IUS - ovulation still happens but IUS stops fertilisation by affecting the cervical mucus and endometrium
They last for up to 5-10 years
Effects/side effects immediately reversible when removed
Your periods can be heavier, longer or more painful in the first 3 to 6 months after an IUD/IUS is put in.
What are the options for emergency contraception?
Levonorgestrel pill (levonelle) take within 72 hours
Ulipristal pill (ellaone) take within 120 hours - More contraindications
Copper IUD most effective - fit within 120 hours of unprotected sex
How soon after delivering a baby can you get pregnant?
21 days
How soon after having a miscarriage or abortion can you get pregnant?
5 days
Is breast feeding a contraceptive?
Yes but only for the first 6 months and only if the woman is feeding every 4 hours and is not menstruating
Irreversible contraceptive options
Female sterilisation
Vasectomy
Abortion
