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Block 8 Ellen > Contraception L7 > Flashcards

Contraception L7 Flashcards

1
Q

What is a LARC

A

long acting reversible contraception

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2
Q

name three natural methods of contraception

A

fertility awareness method (FAM)
Lactational amenorrhoea methods (LAM)
Coitus interruptus (withdrawal)

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3
Q

what does ovulation always happen

A

14 days before the end of a cycle

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4
Q

which stage of ovulation is constant

A

luteal

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5
Q

which stage of ovulation varies

A

follicular

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6
Q

maximum sperm survival=

A

7 days

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7
Q

average egg survival=

A

24 hours

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8
Q

fertile window=

A

8-9 days

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9
Q

when is conception most likely to occur

A

following ovulation or the day preceding

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10
Q

what are some fertility indicators (3)

A

temperature
cervical secretions
calendar

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11
Q

in FAM what causes a higher efficacy

A

higher motivation

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12
Q

are fertility monitoring devices licensed for contraceptive use

A

no

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13
Q

advantages to FAM (3)

A

no hormones
no alteration to menstrual cycle
helps with contraception in future

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14
Q

disadvantages to FAM (3)

A

less effective
no intercourse for at least 8-9 days
no protection from STI

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15
Q

What is LAM

A

lactational amenorrhoea method

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16
Q

What do you need to be to use LAM

A

fully breastfeeding

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17
Q

what does breastfeeding increase production of

A

prolactin

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18
Q

what does prolactin do (story)

A

suppress release of GnRH from hypothalamus which interrupts the release of LH and FSH from anterior pituitary and suppresses ovulation

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19
Q

what is the time zone for LAM

A

6/12 months post partum

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20
Q

what is coitus interruptus

A

pull out method

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21
Q

what is CHC

A

combined hormonal contraception

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22
Q

Name 3 CHCs

A

COC-pill
CHP-patch
CVR-ring

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23
Q

what hormones do CHCs release

A

Progesterone and oestrogen

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24
Q

what is the mode of action for CHCs

A

inhibition of ovulation via action on the hypothalamus-pituitary-ovarian axis to reduce LH and FSH

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25
Q

what do the first 7 pills of COC do

A

inhibit ovulation

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26
Q

what do the remaining 14 pills of COC do

A

maintain anovulation

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27
Q

what is the bleed because off in COC taking

A

because of the withdrawal of hormones

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28
Q

where can’t you place the combined patch

A

breast

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29
Q

name 5 contraindications of CHCs

A 
migraine with aura
family history of VTE
multiple risk factors for CVD
smoking over 35
breast cancer
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30
Q

what is dangerous about taking antibiotics and the pill

A

if you get diarrhoea and vomiting

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31
Q

what drugs may increase the metabolism of the pill

A

liver enzyme inducers —> interfere with cytochrome P450

32
Q

what emergency contraceptive can stop the pill working

A

ella one

33
Q

3 disadvantages of CHC

A

increased risk of VT
increased risk of stroke
increased risk of cervical cancer

34
Q

when is your risk of VT highest (higher then being on pill)

A

in pregnancy

35
Q

which generation pills carry a higher risk of VT

A

3rd and 4th gen

36
Q

main contraindication for progesterone only pill

A

breast cancer

37
Q

when can you start progesterone pill

A

any time as long as you’re not pregnant

38
Q

how long does the progesterone pill start to work

A

quickly within 48 hours

39
Q

advantage of progesterone pill (3)

A

no delay in return to fertility
can be used until age 55
very safe

40
Q

main disadvantage of progesterone only pill

A

irregular bleeding pattern

41
Q

what is the progesterone injection called

A

depo provera

42
Q

what is sayana press

A

newer self administration progestogen injectable

43
Q

what is the injection interval for progestogen injectables

A

12 weeks

44
Q

when can’t you use depo provera

A

under 18 or over 44 (higher risk of osteoporosis)

45
Q

advantages of Progestogen injectable

A

reduced bleeding - most amenorrhoeic by 12 months
can reduce pain
LARC

46
Q

disadvantage of progestogen injectable (3)

A

can’t remove once given
delay in fertility return up to 1 yr
small loss of BMD

47
Q

how long is the progestogen implant licensed for

A

3 years

48
Q

what is the most effective preventer of contraception

A

progestogen only implant

49
Q

what makes the progesterone implant less effective

A

gaining lots of weight

50
Q

side effect of implant

A

altered bleeding patterns

51
Q

advantages of progesterone implant

A

very safe
LARC
rapid return to fertility

52
Q

disadvantage of progesterone implant

A

irregular bleeding patterns
some experience weight gain
risk of fitting

53
Q

2 forms of intra-uterine contraception

A

copper IUD

Levonorgestrel IUS

54
Q

cautions for intrauterine methods (3)

A

arrhythmias from fitting coil
current pelvic infection
unexplained vaginal bleeding

55
Q

What must always be done before fitting the coil

A

STI risk assessment

56
Q

2 types of levonorgestrel IUS

A

mirena

jaydess

57
Q

which levonogestrel lasts longer and is bigger

A

Mirena (5 years)

58
Q

what is amenorrhoea

A

absence of a menstrual cycle

59
Q

which levonorgestrel is more likely to cause amenorrhoea

A

mirena

60
Q

advantages of IUS (4)

A

LARC
fit and forget
reduction in bleeding and pain
immediate return to fertility

61
Q

disadvantages of IUS

A

risks with fitting

relies on a health professional to fit and remove

62
Q

mechanism of copper IUD

A

copper toxic to ovum and any sperm= affects fertilisation

63
Q

disadvantages of copper coil

A

risks of fitting
heavier longer periods
relies on health professional to fit and remove

64
Q

3 emergency contraceptives

A

IUD (intrauterine device)
Ulipristal (ella one
levonorgestrel

65
Q

what is bad about ella one

A

interacts with other contraceptives

bad with severe asthma

66
Q

what is the most effective emergency contraceptive

A

emergency IUD

67
Q

in IUD what prevents implantation

A

Endometrial inflammation reaction

68
Q

up to how many days can the emergency IUD be inserted

A

5 days after unprotected sex or 5 days after ovulation

69
Q

what needs to be done 3 weeks after fitting emergency IUD

A

follow up pregnancy test

70
Q

what is ellaone (ulipristal acetate UPA)

A

selective progesterone receptor molecule

delays ovulation 5 days

71
Q

how many times in a cycle can ellaone be given

A

twice

72
Q

difference with levonorgestrel and ellaone

A

levonorgestrel doesn’t interfere with ongoing contraception

73
Q

3 barrier methods of contraception

A

male condom
female condom
diaphragms

74
Q

when should a diaphragm not be used

A

history of toxic shock syndrome

75
Q

bonus of condoms

A

protect against STIs

76
Q

if adding lubricant what condoms should be used

A

water based

77
Q

female sterilisation 2 methods

A

laparoscopy tubal ring

transvervical essure micro insert

Block 8 Ellen (14 decks)

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