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Yr 3 - Reproduction > Contraception Lecture > Flashcards

Contraception Lecture Flashcards

1
Q

Which are the most common forms of contraception?

A

Combined pill

Sterilisation

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2
Q

What is the ideal contraceptive?

A 
Reversible
Effective (100%)
Unrelated to intercourse
No side effects
Protective against STI
Non-contraceptive benefits
Low maintenance
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3
Q

What is the Pearl Index?

A

Number of contraceptive failures per 100 women-years of exposure

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4
Q

What is the Life Table Analysis?

A

Contraceptive failure rate over a specified time-frame, gives cumulative failure rate

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5
Q

What is method failure?

A

Pregnancy despite correct use of method by user

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6
Q

What is user failure?

A

Pregnancy because method not correctly used

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7
Q

Why does long-acting reversible contraception have the lowest failure rates?

A

Minimises user input

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8
Q

When do women most likely ovulate during their cycle?

A

12-18 days

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9
Q

How long does an egg survive post-ovulation?

A

24hrs

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10
Q

How long does sperm survive in the uterus?

A

<4 days

5% survive 7 days

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11
Q

When is the chance of pregnancy highest?

A

Days 8-19

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12
Q

Which hormones are contained in combined hormonal contraception?

A

Ethinyl estradiol

Synthetic progesterone

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13
Q

What is the effect of combined hormonal contraception?

A

Stops ovulation

Affects cervical mucus and endometrium

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14
Q

What problems are associated with a daily pill?

A

Ineffective if frequent GI upset

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15
Q

What problems are associated with a patch EVRA?

A

<5% have a skin reaction

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16
Q

What regimes can be used for combined hormonal contraception?

A 
Standard regime (21 on, week off)
Tailored regimes to avoid bleeding
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17
Q

What are the non-contraceptive benefits of combined methods?

A 
Regulate bleeding
Stop ovulation (can stop PMS)
Reduction of function ovarian cysts
50% reduction in ovarian/endometrial cancers
Improve acne/hirsutism
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18
Q

Which diseases have reduced rates associated with combined methods?

A

Benign breast disease
Rheumatoid arthritis
Colon cancer
Osteoporosis

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19
Q

What side effects are associated with the combined methods?

A 
Breast tenderness
Nausea
Headache
First 3mo - irregular bleeds
Mood effects
Weight gain
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20
Q

What serious risks are associated with combined methods?

A

Increased risk thrombosis (venous and arterial)
Gall bladder disease
Breast cancer

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21
Q

Combined methods should be avoided in who?

A 
BMI >34
Previous VTE
FH VTE
Thrombophilic diseases
Smokers >35
Hypertensive
Age >50
PMH arterial thrombosis
Liver tumours
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22
Q

What are the contraindications for progestogen-only pill?

A

Personal history of Breast cancer or liver tumours

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23
Q

What side effects are associated with progestogen only pills?

A 
Appetite increase
Hair loss
Mood change
Bloating
Headache
Acne
24
Q

What is the effect of injectable progestogen?

A

Prevents ovulation
Alters cervical mucus
Makes endometrium unsuitable for implantation

25
What are the advantages of injectable progestogen?
Every 12 weeks 70% women amenorrhoeic after 3 doses Estrogen-free
26
What are the disadvantages of injectable progestogen?
Delayed return to fertility (9mo) Reduced bone density Problematic bleeding first 2 doses Weight gain 2/3 women
27
Which contraceptive method has a causal link with weight gain, delayed fertility return and decreased bone density?
Injectable Progestogen
28
What are the advantages of progestogen implant?
``` Inhibits ovulation + effect of cervical mucus Can last 3 years Removable No user input No causal effect on weight ```
29
What are the disadvantages of progestogen implant?
60% bleed free 30% prolonged bleed Mood changes Unpredictable bleeding
30
What are the advantages of intrauterine contraception?
No user input Any age/parity Easily reversible
31
What are the disadvantages of intrauterine contraception?
Small infection risk Risk perforation Risk expulsion (check threads after period) Conceptions may be ectopic
32
What are the advantages of copper IUD?
Hormone free | 5-10 years
33
What are the disadvantages of copper IUD?
Heavier crampier periods
34
How does the Levonorgestrel IUS work?
Affect cervical mucus and endometrium Slow release progestogen Low circulating progestogen compared to other methods
35
What are the benefits of the Mirena coil?
5 years duration | 85% of women bleed free by 1 year
36
What are the main forms of emergency contraception?
Copper IUD (most effective) Levonelle pill Ellaone pill
37
How must Levonelle be taken?
Take within 72hrs
38
How must ellaone be taken?
Take within 120hrs
39
When is Ellaone contraindicated?
Breast feeding Enzyme inducing drugs Acid reducing drugs
40
When should you start contraception?
Immediate cover - first 5 days of cycle | Other times - abstain for 7 days, pregnancy test after 4 weeks
41
When can you get pregnant after delivery?
21 days
42
When can you get pregnant after miscarriage/abortion?
5 days
43
When does breastfeeding function as a contraceptive?
First 6 months, if feeding every 4hrs and amenorrhoeic
44
What are the disadvantages of female sterilisation?
Surgery risks Regret 1 in 200 failure rate - ectopic No effect on periods/hormones
45
What are the advantages of female sterilisation?
Reduced ovarian cancer risk
46
How long does vasectomy take to become effective?
4-5 months (2 sperm samples at 4 and 5 months)
47
What is the failure rate of vasectomy?
2 in 100 | 1 in 2000 after 2 clear samples
48
What age group are most likely to have an abortion?
20-24
49
What is a doctors obligation in abortion?
A doctor is obligated to ENSURE a woman is ABLE to access abortion care
50
What should be covered in an abortion clinic consultation?
Methods of abortion What to expect and when to seek advice Contraception/use advice
51
What complications are associated with surgical abortion?
1-4:1000 perforation Infection Risks from GA
52
Which drugs are used for medical abortion
Mifepristone oral antiprogestogen | 48hrs after Misoprostol to expel pregnancy
53
When can a surgical abortion be given?
5-12 weeks
54
When can medical abortion be given?
5-24 weeks
55
What complications are associated with medical abortion?
``` Failure 1 in 100 <8 weeks Failure 8 in 100 >12 weeks (need surgery if incomplete) Infection - prophylactic antibiotics <1 in 1000 need blood transfusion ```

Yr 3 - Reproduction (37 decks)

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