Contraception L7 Flashcards
What is a LARC
long acting reversible contraception
name three natural methods of contraception
fertility awareness method (FAM)
Lactational amenorrhoea methods (LAM)
Coitus interruptus (withdrawal)
what does ovulation always happen
14 days before the end of a cycle
which stage of ovulation is constant
luteal
which stage of ovulation varies
follicular
maximum sperm survival=
7 days
average egg survival=
24 hours
fertile window=
8-9 days
when is conception most likely to occur
following ovulation or the day preceding
what are some fertility indicators (3)
temperature
cervical secretions
calendar
in FAM what causes a higher efficacy
higher motivation
are fertility monitoring devices licensed for contraceptive use
no
advantages to FAM (3)
no hormones
no alteration to menstrual cycle
helps with contraception in future
disadvantages to FAM (3)
less effective
no intercourse for at least 8-9 days
no protection from STI
What is LAM
lactational amenorrhoea method
What do you need to be to use LAM
fully breastfeeding
what does breastfeeding increase production of
prolactin
what does prolactin do (story)
suppress release of GnRH from hypothalamus which interrupts the release of LH and FSH from anterior pituitary and suppresses ovulation
what is the time zone for LAM
6/12 months post partum
what is coitus interruptus
pull out method
what is CHC
combined hormonal contraception
Name 3 CHCs
COC-pill
CHP-patch
CVR-ring
what hormones do CHCs release
Progesterone and oestrogen
what is the mode of action for CHCs
inhibition of ovulation via action on the hypothalamus-pituitary-ovarian axis to reduce LH and FSH
what do the first 7 pills of COC do
inhibit ovulation
what do the remaining 14 pills of COC do
maintain anovulation
what is the bleed because off in COC taking
because of the withdrawal of hormones
where can’t you place the combined patch
breast
name 5 contraindications of CHCs
migraine with aura family history of VTE multiple risk factors for CVD smoking over 35 breast cancer
what is dangerous about taking antibiotics and the pill
if you get diarrhoea and vomiting
what drugs may increase the metabolism of the pill
liver enzyme inducers —> interfere with cytochrome P450
what emergency contraceptive can stop the pill working
ella one
3 disadvantages of CHC
increased risk of VT
increased risk of stroke
increased risk of cervical cancer
when is your risk of VT highest (higher then being on pill)
in pregnancy
which generation pills carry a higher risk of VT
3rd and 4th gen
main contraindication for progesterone only pill
breast cancer
when can you start progesterone pill
any time as long as you’re not pregnant
how long does the progesterone pill start to work
quickly within 48 hours
advantage of progesterone pill (3)
no delay in return to fertility
can be used until age 55
very safe
main disadvantage of progesterone only pill
irregular bleeding pattern
what is the progesterone injection called
depo provera
what is sayana press
newer self administration progestogen injectable
what is the injection interval for progestogen injectables
12 weeks
when can’t you use depo provera
under 18 or over 44 (higher risk of osteoporosis)
advantages of Progestogen injectable
reduced bleeding - most amenorrhoeic by 12 months
can reduce pain
LARC
disadvantage of progestogen injectable (3)
can’t remove once given
delay in fertility return up to 1 yr
small loss of BMD
how long is the progestogen implant licensed for
3 years
what is the most effective preventer of contraception
progestogen only implant
what makes the progesterone implant less effective
gaining lots of weight
side effect of implant
altered bleeding patterns
advantages of progesterone implant
very safe
LARC
rapid return to fertility
disadvantage of progesterone implant
irregular bleeding patterns
some experience weight gain
risk of fitting
2 forms of intra-uterine contraception
copper IUD
Levonorgestrel IUS
cautions for intrauterine methods (3)
arrhythmias from fitting coil
current pelvic infection
unexplained vaginal bleeding
What must always be done before fitting the coil
STI risk assessment
2 types of levonorgestrel IUS
mirena
jaydess
which levonogestrel lasts longer and is bigger
Mirena (5 years)
what is amenorrhoea
absence of a menstrual cycle
which levonorgestrel is more likely to cause amenorrhoea
mirena
advantages of IUS (4)
LARC
fit and forget
reduction in bleeding and pain
immediate return to fertility
disadvantages of IUS
risks with fitting
relies on a health professional to fit and remove
mechanism of copper IUD
copper toxic to ovum and any sperm= affects fertilisation
disadvantages of copper coil
risks of fitting
heavier longer periods
relies on health professional to fit and remove
3 emergency contraceptives
IUD (intrauterine device)
Ulipristal (ella one
levonorgestrel
what is bad about ella one
interacts with other contraceptives
bad with severe asthma
what is the most effective emergency contraceptive
emergency IUD
in IUD what prevents implantation
Endometrial inflammation reaction
up to how many days can the emergency IUD be inserted
5 days after unprotected sex or 5 days after ovulation
what needs to be done 3 weeks after fitting emergency IUD
follow up pregnancy test
what is ellaone (ulipristal acetate UPA)
selective progesterone receptor molecule
delays ovulation 5 days
how many times in a cycle can ellaone be given
twice
difference with levonorgestrel and ellaone
levonorgestrel doesn’t interfere with ongoing contraception
3 barrier methods of contraception
male condom
female condom
diaphragms
when should a diaphragm not be used
history of toxic shock syndrome
bonus of condoms
protect against STIs
if adding lubricant what condoms should be used
water based
female sterilisation 2 methods
laparoscopy tubal ring
transvervical essure micro insert
