E1. Contraception Flashcards
what is contraception?
The prevention of CONCEPTION by the use of birth control devices or methods.
what are the two main types of contraception?
- non-hormonal
-hormonal
Contraception can be either permanent or temporary
types of non-hormonal and hormonal contraception?
ONE NOTE
Describe condoms
Female- worn inside the vagina to prevent semen getting into the womb- 95% effective
Male- stop a man’s semen coming into contact with his sexual partner
-98% effective
STI protection
Describe diaphragms
-Cups made of silicone that are inserted into the vagina to cover the cervix
-If used with spermicide 92-96% effective
-Little STI Protection
Describe intrauterine device – Copper Coil
-Small T-shaped device made of plastic & copper-Different from intrauterine systems which contain progestogens
-Causes thickening of the cervical mucus making it more difficult for the sperm to reach the egg.
-It can also stop a fertilised egg from being implanted.
-They are inserted by a doctor or a nurse and can remain in situ for up to 10 years.
-If inserted correctly they are 99% effective.
-They do not protect against STIs.
Describe fertility awareness method
-Method of contraception where a woman monitors & records different fertility signals during her menstrual cycle
-‘Natural Family Planning’ or ‘Rhythm Method’
-Can be up to 99% effective
-Takes 3-6 months to establish
-Affected by stress, travel, illness
-Doesn’t protect against STIs
-Numerous apps e.g. Natural Cycles
Describe surgical Intervention- male sterilisation
-Vasectomy
-Surgical procedure to cut or seal the tubes that carry a man’s sperm
>99% effective
-No STI protection
Describe surgical intervention- female sterilisation
-Fallopian tubes are blocked/sealed to prevent the eggs reaching the sperm
>99% effective
-no STI protection
Describe the mode of action for hormonal contraception
-Oestrogen suppresses Ovulation
-Progestogen Prevents sperm reaching egg and Prevents implantation
ONE NOTE
Describe Combined Oral Contraceptive Pill (COCP)
Oestrogen and progestogen
ONE NOTE
Describe monophasic COCP
-Monophasic 21days- fixed amount of hormones, 21 active pills, then 7 day pill free interval
-Monophasic 28 days- fixed amount of hormones, 21 active pills, then 7 dummy pills, improves compliance
Describe phasic COCP
-Variable amounts of hormones according to stage of cycle
-21 day and 28 day varieties
-Helpful for breakthrough bleeding with monophasic pill
-no withdrawal bleed
Describe standard use regimen
-period of CHC use: 21 days (21 active pills or 1 ring, or 3 patches)
-HFI: 7 days
Describe shortened hormone- free interval (HFI) regimen
-Period of CHC use: 21 days (21 active pills or 1 ring, or 3 patches)
-HFI: 4 days
Describe extended use (tricycling) regimen
-period of CHC use: 9 weeks (3x 21 active pills or 3 rings, or 9 patches used consecutively)
-HFI: 4 or 7 days
Describe flexible extended use regimen
-Period of CHC use: continuous use (>21 days) of active pills, patches or rings until breakthrough bleeding occurs for 3-4 days
-HFI: 4 days
Describe continuous use regimen
-Period of CHC use: continuous use of active pills, patches or rings
-HFI: none
Describe the different categories of COCP risk factors
ONE NOTE
Describe the risk factor of a migraine with COCP
-Use COCP with caution
-Contraindication if new onset or Migraine with aura
-Increased (relative) risk of ischaemic stroke
Describe the risk factor of DVT (Deep Vein thrombosis) with COCP
-3 to 3.5 fold increased (relative risk) VTE risk
-Lower than VTE risk in pregnancy
-Risk highest on initiation
ONE NOTE
Describe the risk factor of breast and cervical cancer with COCP
-small increased risk
-risk diminishes after stopping
-no risk 10 years after stopping
what are other COCP benefits?
-reduced menstrual syndrome
-reduced heavy menstrual bleeding
-reduced menstrual pain
-Improved acne
-Improved PCOS
What are COCP benefits for cancer?
-Ovarian cancer: reduced risk, duration dependent
-Endometrial cancer: reduced risk, persists after stopping
-Colorectal cancer: reduced risk
