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REPRODUCTION & GYNAECOLOGY > Contraception (LARC) > Flashcards

Contraception (LARC) Flashcards

1
Q

What physical reasons do people have for having consensual sex?

A
  • Pleasure
  • Release of sexual tension
  • Attraction to one person
  • Stress relief
  • Mood booster
  • Exercise
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2
Q

What emotional reasons are there for consensual sex?

A
  • Love
  • Commitment
  • Sexual curiosity and novelty
  • Nurturance => create/maintain intimacy
  • Gratitude
  • Need for affection
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3
Q

What insecurity reasons may cause people to have consensual sex?

A
  • boost self-esteem/ social status
  • keep partner
  • Feeling “sense of duty”
  • Internal pressure (to fit in)
  • External pressure (partner(s), peers, social media)
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4
Q

What goal-based reasons may cause people to have consensual sex?

A
  • To improve social status and reputation
  • To enhance power
  • To seek revenge or foster jealousy
  • For financial/material gain
  • To make a baby
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5
Q

How many women get pregnant in a year if they are NOT using contraception?

A

85% of women get pregnant in a year

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6
Q

How many pregnancies in the UK are unplanned?

A

40%

Unplanned pregnancies DO NOT mean they are unwanted!

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7
Q

If a woman is faced with an unplanned pregnancy, what options does she have?

A
  • Have the baby and keep it
  • Termination of pregnancy
  • Have a baby and give it up for adoption
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8
Q

What are the 3 mechanisms of action of contraception?

A

Prevention of ovulation
Prevention of fertilisation
Prevention of implantation

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9
Q

What contraceptive methods prevent ovulation?

A
  • hormonal methods (including emergency contraception)
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10
Q

What contraceptive methods prevent fertilisation?

A
  • condoms
  • diaphragm + spermicide
  • female and male sterilisation
  • IUD
  • hormonal methods (cervical mucous effect creates physical barrier)
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11
Q

What contraceptive methods prevent implantation?

A
  • IUD (especially copper “coil” when used as emergency
    contraception)
  • hormonal methods (hostile endometrium => egg doesn’t want to implant)
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12
Q

How are contraceptives normally classified?

A

Hormonal - COCP, POP, Vaginal Ring, Patch, Injection, Implant

Barrier methods - condoms, diaphragm(plus spermicide)

Intrauterine - copper “coil” IUD, hormone “coil”- IUS

Permanent - sterilisation

“Fertility awareness methods”- • Temperature, calendar, cervical secretion monitoring

Emergency Methods - Copper IUD, Pill

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13
Q

What is the difference in terminology between “Family planning”, “Contraception” and “Birth control”?

A

Birth control includes the possibility of abortion

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14
Q

What are the main things to consider when choosing the best contraceptive method with a patient?

A
  • their personal preference
  • age
  • life situation
  • non-contraceptive benefits
  • accessibility of method
  • medical eligibility/ contraindications to any methods
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15
Q

What non-contraceptive benefits can hormonal contraception give?

A
  • lighter, more regular periods
  • less intermittent bleeding
  • less PMS
  • less breast tenderness
  • less Ovarian cysts, Endometriosis and Ovarian cancer (if ovulation is suppressed)
  • less Acne
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16
Q

What is perfect vs typical use of a contraceptive?

A

Perfect - as if a robot was using it (=> eliminates user failure)
Typical - average of normal people using the method

17
Q

How can user failure occur in patients using barrier methods such as condoms or a diaphragm?

A

Condoms:

  • used too late
  • wrong lube (oil-based)
  • wrong technique
  • inconsistent use
  • wrong storage

Diaphragm:

  • used too late
  • removed too early
  • wrong technique
  • inconsistent use
  • no damage checks
  • no replacements
18
Q

How can hormonal forms of contraception be used wrongly by patients?

A
  • poor compliance/ late injection
  • wrong use/storage (ring)
  • Late replacement when coming off
  • drug interaction with OTC drugs (St John’s Wort),
  • no extra precaution when quickstarting
19
Q

How can user failure be caused iatrogenically?

A

Not enough guidance given on initiation of contraceptive method

20
Q

What are the main disadvantages and risks of intrauterine devices/systems?

A
  • Invasive
  • Quick but often painful insertion
  • risk of perforation, PID, malposition/expulsion
21
Q

HOw long can the copper IUD last after insertion?

A

10 years

22
Q

What is one drawback of the copper coil that presents within the first 3 months?

A
  • makes periods heavier, longer and more painful, during the first 3 months post insertion
23
Q

What patient group may the copper coil be suitable for if they cannot have additional hormones?

A
  • women after breast cancer
24
Q

What other uses does the Mirena coil have other than contraception?

A
  • treats heavy periods
  • part of HRT
  • OTHERS - endometriosis, hyperplasia etc
25
Q

Spotting common in the weeks or months after insertion. TRUE/FALSE?

A

TRUE

26
Q

What percentage of patients with a Mirena coil experience amenorrhoea by 6 months after insertion?

A

≈ 50% of amenorrhoea on Mirena® at 6/12

27
Q

How long does the Nexplanon implant last in women?

A

3 years

28
Q

What are the main disadvantages to the Nexplanon implant?

A
  • invasive

- Main side effect: prolonged PV bleeding

29
Q

How can the prolonged bleeding on the Nexplanon implant be treated?

A

With the combined oral contraceptive pill

REPRODUCTION & GYNAECOLOGY (58 decks)

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