Contraception Flashcards
When does ovulation occur?
10-16 days before the next period
How long can eggs live until fertilised with sperm?
24hrs
How long can sperm live inside female for
7 days
When should sex be avoided if performing fertility awareness?
48 hours after ovulation and 7 days prior to ovulation
What is a vasectomy
Cutting or tying of the vas deferens
Describe tubal ligation
Fallopian tubes are blocked by surgery
Describe hysterectomy
Removal of uterus
State the two types of pill
Combined pill (oestrogen and progesterone) Progesterone only pill
How does the combined pill work?
-ve feedback loop to hypothalamus to suppress LH and FSH to inhibit ovulation
Describe MOA of progesterone only pill
- Thickens cervical mucus making it more difficult for sperm to fertilise egg
- Thins the lining of the uterus making it less likely a fertilised egg can implant
- Some POPs contain desogesterol that prevents ovulation by modifying action of LH and FSH to inhibit ovulation
2 differences of POP and combined pill
- Progesterone is always taken whereas combined pill taken for 21 days then a 7 day break
- Progesterone only is safe for smoker but combined isn’t due to increase risk of deep vein thrombrosis
What do both oral contraceptives also treat?
Painful periods and endometriosis (combined pill more effective)
Which pill can cause irregular or infrequent periods?
Progesterone only
How does combined pill reduce risk of endometrial and ovarian cancers
Reduces number of ovulations (decrease ovarian cancer)
Suppresses endometrial cell proliferation
How does combined pill increase risk of breast cancer
Additional oestrogen
Rules for progesterone only pill
- Immediate protection if started in day 1-5 of cycle
- If started on any other day use contraception for 2 days
- If pill is missed in 3-12 hour window take next pill asap and continue as normal
- If pill missed outside 12 hour window take pill asap then as usual but use contraception for 48 hours
Rules for combined pill
- If started on days 1-5 protection is immediate
- If started after day 5 contraception is needed for 7 days
- If one pill missed take ASAP then continue as normal
- If 2 pills missed take asap (max 2 in one day) then continue as normal but use contraception for 7 days
Which contraception should be avoided if patient has migraines (with aura)
Combined pill
Describe MOA of copper coil
Small amounts of copper released which increases cervical mucosa and prevents implantation of egg
Describe MOA of levonorgestrel intrauterine system (mirena) coil
Similar to progesterone only pill
- Thickens cervical mucosa
- Thins uterus lining
- Can prevent ovulation
How long does copper coil last
5-10 years
How long does mirena coil last
3-5 years
Which coil may result in heavier periods?
Copper
Which coil may result in lighter (infrequent) periods
Mirena
Describe MOA of contraceptive implant
Steadily releases progesterone into blood to prevent ovulation, thickens cervical mucosa and thins uterus lining
How long should patient use contraception with contraceptive implant?
If inserted at first 5 days of cycle protection is immediate
If any other day use contraception for 7 days.
How often is contraceptive injection given?
Every 13 weeks
When does protection start using contraceptive injection?
In first 5 days protection is immediate. Any other day requires other contraception for 7 days
