Contraception, Infertility, PCOS, Menopause - Dr Usama BW3 Flashcards
Contraception:
Conception rate:
Menstrual cycle:
Follicular development:
Pituatary and ovarian hormone levels
Endometrials cycle (thickness)
LH peaks causes Ovulation: - corpeus luteum
Natural family planning:
What is lactatioonal amenorrhoea?
Explain? Issues relying on it? How long does it owork?
Condoms (males)
benefits? Risks?
Female condoms: Risks benefits
fds
COCP=
COCP? Vaginal ring?
What does the COCP actually do to stop someone getting pregnant-????
Suppreses LH surge mid cycle
THickens cervical mucus
Pros vs Cons - COCP:
- Mode Of treatment for PMS
- Excessicve androgen - PCOS
- Cheap - effective
- missed pills - catch up
- still gets sti
Contraindication to COCP
Other uses of COCP
Menohaggia
acne
Hiritusims
Managing side effects of COCP
Acne
Headaches
Nauseas (estrogen)
Lower libidio+ Mood changes - Use copper
Breakthrough bleeding
How does the progesterone only pill work?
Advantages vs disadvantages
LARC: Long acting reversible contraception
What are the major benefits?
What is Depo-provera? What is it? How often? How does it work?
Depo-provera- Advantages/diasadvantages
Explain - Advantages vs disadvantages
What do you need to do with this? (DEXA scan) - M
Often used in patients with intelectual disability
Implanon: Pros vs Cons:
How long does it last?
How does it work?
Intrauterine contraceptive devices:
Mirena: Pros vs Cons
Better side effect profile:
Localised effect vs systemic: Can be used to menorrhagia, amenhorrhoea rates high.
Can be painful to insert:
Serious side effects? LIST
- Uterine perforation!!! (complication) (young and old- more common)
- Expulsion - Can occur in women with heavy periods
- Infection: Foriegn body- PID (discharge , pain fever)
- may causes pt increase Ovarian cysts
Copper IUDS:
Pro vs vs cons
f
Permanent Contraception:
Tubal ligation
Salpingectomy
Vasectomy
Pros vs Cons ???
- Usually added onto C section- (when pt has had enough kids)
- Surgical risk: Complications/ adhesions/infections/PID/Damage to bowel and bladder/anaesthetic risk
*
Tubal ligation
Provs vs Cons
Bilateral salpingectomy:
Pros vs Cons
Vasectomy:
Pros Vs Cons
Very safe easy
What is the UK MEC criteria?
What does it do?
Explain
score 1-4
1 all good
4 - contraindicated
Timing of initation:
Late and missed pills: COCP: read up
Explain? Timings?
What do you tell them to do???
Missed progesterone only pill-
Emergency contraception:
What do you need to? What do you need t couensel patient on?
Levonogestre; - LNG EC (Progesterone based- same as mirena)
Emergency copper IUD?
Menopause:
Define?
Average age? Symptoms? when do they begin to occur? How long can it last?
What are primary issues people complain about ?
- Urinary frequency
- Vaginal dryness
- Vaginal atrophy
- Facial flushing
- Mood swings changes
Consequences of menopause?
List 6 complications:
Benefits of menopausal hormone therapy?
What does it help prevent? What is it made up of? (only oestorgen)
If she has uterus (needs progesterone + add mirena)
- Decreases CV risk
- decreases thrombosis risk
List most important risks associated with menopausal hormonal therapy:
- generally should be iniated before the age of 60
- Current safety
- Using testosterone therapy
Fertility: New lecture:
types of infertility?
What are causes of subfertility: female? Male?
PCOS
Clinical syndrome:
Significant psychosocial issues:
How is a diagnosis of PCOS made?
Need 2/3 - Whats the classification called?
What are the 3 criteria?
Other causes of anoovulation? Hyperandrogenism?
Hx examination of PCOS: Outline
Investigations for PCOS: OUtline
Management of PCOS: Principles?
Lifestyles? BMI? Psychological (depression)
Management: Metabolic and long term:
Explain Key points:
Insulin resistance/CVS health (yearly BP and lipid profile), Endometrial (cocp, low threshold)
- LAser/ hair removal-
- COCP - Hiritusim
Management: PCOS- fertilty- getting pregnant with PCOS:
- First line: No treatment until BMI <35
- Letrzole - aromotase inhibitor- Highly effective (inducing ovulation -mimic LH surge)
- Clomiphene- SERM
What are other key points about management of PCOS:
CVS - manage CV risk
Management - Of lipids/ BSL/ sugar resistance/
Use of metformin: