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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
Q

What are the advantages of injectable progestogen?

A

Every 12 weeks
70% women amenorrhoeic after 3 doses
Estrogen-free

26
Q

What are the disadvantages of injectable progestogen?

A

Delayed return to fertility (9mo)
Reduced bone density
Problematic bleeding first 2 doses
Weight gain 2/3 women

27
Q

Which contraceptive method has a causal link with weight gain, delayed fertility return and decreased bone density?

A

Injectable Progestogen

28
Q

What are the advantages of progestogen implant?

A 
Inhibits ovulation + effect of cervical mucus
Can last 3 years
Removable
No user input 
No causal effect on weight
29
Q

What are the disadvantages of progestogen implant?

A

60% bleed free
30% prolonged bleed
Mood changes
Unpredictable bleeding

30
Q

What are the advantages of intrauterine contraception?

A

No user input
Any age/parity
Easily reversible

31
Q

What are the disadvantages of intrauterine contraception?

A

Small infection risk
Risk perforation
Risk expulsion (check threads after period)
Conceptions may be ectopic

32
Q

What are the advantages of copper IUD?

A

Hormone free

5-10 years

33
Q

What are the disadvantages of copper IUD?

A

Heavier crampier periods

34
Q

How does the Levonorgestrel IUS work?

A

Affect cervical mucus and endometrium
Slow release progestogen
Low circulating progestogen compared to other methods

35
Q

What are the benefits of the Mirena coil?

A

5 years duration

85% of women bleed free by 1 year

36
Q

What are the main forms of emergency contraception?

A

Copper IUD (most effective)
Levonelle pill
Ellaone pill

37
Q

How must Levonelle be taken?

A

Take within 72hrs

38
Q

How must ellaone be taken?

A

Take within 120hrs

39
Q

When is Ellaone contraindicated?

A

Breast feeding
Enzyme inducing drugs
Acid reducing drugs

40
Q

When should you start contraception?

A

Immediate cover - first 5 days of cycle

Other times - abstain for 7 days, pregnancy test after 4 weeks

41
Q

When can you get pregnant after delivery?

A

21 days

42
Q

When can you get pregnant after miscarriage/abortion?

A

5 days

43
Q

When does breastfeeding function as a contraceptive?

A

First 6 months, if feeding every 4hrs and amenorrhoeic

44
Q

What are the disadvantages of female sterilisation?

A

Surgery risks
Regret
1 in 200 failure rate - ectopic
No effect on periods/hormones

45
Q

What are the advantages of female sterilisation?

A

Reduced ovarian cancer risk

46
Q

How long does vasectomy take to become effective?

A

4-5 months (2 sperm samples at 4 and 5 months)

47
Q

What is the failure rate of vasectomy?

A

2 in 100

1 in 2000 after 2 clear samples

48
Q

What age group are most likely to have an abortion?

A

20-24

49
Q

What is a doctors obligation in abortion?

A

A doctor is obligated to ENSURE a woman is ABLE to access abortion care

50
Q

What should be covered in an abortion clinic consultation?

A

Methods of abortion
What to expect and when to seek advice
Contraception/use advice

51
Q

What complications are associated with surgical abortion?

A

1-4:1000 perforation
Infection
Risks from GA

52
Q

Which drugs are used for medical abortion

A

Mifepristone oral antiprogestogen

48hrs after Misoprostol to expel pregnancy

53
Q

When can a surgical abortion be given?

A

5-12 weeks

54
Q

When can medical abortion be given?

A

5-24 weeks

55
Q

What complications are associated with medical abortion?

A 
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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