Contraceptives Flashcards
How does the Combined Oral Contraceptive Pill work?
Contains 21 days of oestrogen and progesterone, reducing LH and FSH levels, preventing follicular development, preventing LH surge and subsequent ovulation, and maintaining a thick acidic cervical mucus.
What are common ADRs of the COCP?
Weight gain (salt/water retention and anabolism), irritability, flushing, dizziness, mood changes, acne, post-cessation amenorrhoea, decreased glucose tolerance and breast tenderness.
What conditions are at an increased risk in COCP use?
Venous thromboembolism and breast cancer.
What 2 types of drugs can cause COCP failure?
CYP450 inducers and broad spectrum antibiotics (gut flora loss).
What are some contraindications for COCP use?
Pregnancy, breastfeeding, heart disease, hypertension, smoking, diabetes mellitus, hyperlipidaemia, hypercoagulability, migraines, liver disease, breast or genital cancer.
What groups are better suited for the Progesterone only Pill?
Smokers and people with diabetes, heart disease or hypertension.
What are some POP ADRs?
Menstural irregularities, weight gain, headache and breast tenderness.
What obvious difference will POP users notice from using POP instead of COCP?
They mensturate.
Apart from contraception and menopause, name 2 disorders oestrogen can be used to treat?
Primary amenorrhoea, and primary hypogonadism.
What is the morning after pill, when can it be used and how does it work?
Contains progesterone which prevent implantation, and can be given within 72 hours of unprotected sex.
What are the ADRs of Hormone Replacement Therapy?
Worsened lipid profile, increased thromboembolism risk, increased breast, ovarian and endometrial cancer risk, uterine bleeding.
How do steroid hormones work?
Bind to cytoplasm receptors, form homodimers which bind to DNA and transrepress and transactivate certain genes.
Compare the proteins which carry different sex hormones in the blood.
Albumin carries progesterone, whereas testosterone and oestrogen are carried by sex hormone binding globulin.
Name 3 Selective Oestrogen Receptor Modulators, and what they do.
1) Clomiphene - an antagonist which causes increased GnRH and ovulation. 2) Tamoxifen - mixed agonist/antagonist depending on tissue. Decreased breast cancer risk but increases endometrial cancer risk. 3) Raloxifene - decreases osteoporosis, endometrial cancer and breast cancer risks.
Name an antiprogesterone and what it can be used for.
Mifepristone, used for termination or labour induction.
