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Cardio > Endo-Repro L30 Contraception > Flashcards

Endo-Repro L30 Contraception Flashcards

1
Q

Hormonal contraception

A
  1. Contraceptive pills → Combined pill, progestin0only pill, post-coital pill
  2. Patch
  3. Injectable
  4. Implants
  5. Intrauterine systems (mirena)
  6. Vaginal ring (Nuvaring)
  7. Male pill
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2
Q

Combined oral contraceptive pill (COCP): Definition

A

Mix of estrogen and progestogen

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3
Q

Combined oral contraceptive pill (COCP): Mechanism of action (2)

A 
1st prevention ovulation
•	Remove normal cycle, withdrawal bleed has minimal medical significance
2nd Cervical mucus
•	Thick (progesterone)
→Fallopian tubes
→Endometrium
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4
Q

Combined oral contraceptive pill (COCP):Advantages

A 
Effective and easy to use
Convenient
Not intercourse related
Reversible
Periods (lighter, timed or no periods)
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5
Q

Combined oral contraceptive pill (COCP):Reduction in

A

PMS
Ovarian cysts and cancer
Benign breast disease

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6
Q

Combined oral contraceptive pill (COCP): Disadvantages

A

Forget-ability

Needs planning

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7
Q

Combined oral contraceptive pill (COCP): Side effects

A 
Nausea and vomiting
Irregular bleeding
Tiredness change
Change in sex drive
Weight gain?
Sore breasts
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8
Q

Combined oral contraceptive pill (COCP): Risk factor for

A

VTE
Arterial disease
History of focal migraines

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9
Q

Contraceptive patches and vaginal ring →

A

same as COCP except wear or insert for 3 weeks then have one week off.

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10
Q

Progesterone only pill → General principles

A

Low dose of progestogen through out cycle

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11
Q

Progesterone only pill → Mechanism of action

A 
1.	Cervical mucus
•	Thick (progesterone
2.	Fallopian tubes
3.	Endometrium
4.	Prevents ovulation:
•	Cerazette
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12
Q

Progesterone only pill → Progestogen action on fallopian tubes

A

It is a smooth muscle relaxant and therefore cant contract to move egg.

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13
Q

Progesterone only pill → Advantages

A
  1. Effective and easy to use
  2. Convient
  3. Not intercourse related
  4. Reversible
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14
Q

Progesterone only pill →Can use if

A 
>35 yrs
Smoker
Obese
During lactation/breast feeding
High BP or Migraine/DM
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15
Q

Progesterone only pill →Disadvantages

A

Forget ability →
• 3hrs with standard POP
• 12 hrs with Cerazette

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16
Q

Progesterone only pill → Side effects

A
  • Irregular bleeding
  • Functional ovarian cysts
  • Headaches, weight, spots, breast tenderness
17
Q

Post-coital (Emergency) contraceptive: Examples

A

Levonelle
EllaOne
Emergency IUD

18
Q

Levonelle

A

Is a tablet containing a hormone called progestogen. 1 pill (within 72 hours)

19
Q

Ellaone

A 
A tablet containing ullipristal (progestogen receptor blocker)
1 pilll (120 hours)
20
Q

Emergency IUD

A

Is a small plastic and copper device that is fitted in your uterus up to five days (120 hours) after unprotected sex or within five days of the earliest time you could have released an egg.

21
Q

Mechanism of action Levonelle

A

Levonorgestrel (levonelle)
• Progestogen hormone
• Prevents/delays ovulation if given early in the cycle – seems to prevent follicular rupture or cause luteal dysfunction
• Disrupts egg transport

22
Q

Advantages Levonelle

A
  • Allows a mistake to be corrected.
  • No prescription needed
  • No affect if one does become/is pregnant
23
Q

Side effects Levonelle

A
  • Nausea, vomiting, headache
  • Menstrual disturbance
  • May not work
24
Q

Mechanism of action Ella one

A

Ullipristal acetate is a progestrogen receptor modulator
Prevents/de;ays ovulation if given early in the cycle
No current evidence on disruption of embryp-endometrial interface.

25
Q

Advantages ellaone

A
  • Allows a mistake to be corrected.

* No affect if one does become/is pregnant

26
Q

Side effects ellaone

A
  • Nausea, vomiting, headache
  • Menstrual disturbance
  • May not work
27
Q

Mechanism of action cooper IUD

A

Disrupts egg transport and implantation (conception is at time of implantation not fertilisation

28
Q

Consider with copper IUD

A

Antibiotics

29
Q

Advantages copper IUD

A

Allows a mistake to be corrected
Can be inserted up to 120 hours after the first episode of unprotected sex intercourse (UPSI) or within 5 days of the earliest expected date of ovulation.

30
Q

Side effects of copper IUD

A

Menstrual disturbance

May not work

31
Q

Intrauterine Devices (IUD) → copper/plastic Mechanism of action

A
  1. Cause mild inflammatory response
  2. Cause toxic environment reducing survival of gametes and embryo
  3. Disrupt inflammation (may inhibit endometrial enzymes)
32
Q

Intrauterine Devices (IUD) → copper/plastic Advantages

A

Work long-term, and are highly effective
Non-intercourse related
No user error

33
Q

Intrauterine Devices (IUD) → copper/plastic Disadvantages

A

Have to be fitted by an expert
Heavier periods
May be expelled or displaced
Increased risk of ectopic pregnancy

34
Q

IUS (Mirena): Mechanism of action

A
  1. Increases the thickness of cervical mucus
  2. Thinning of the endometrium (prevents implantation)
  3. Preventing ovulation
35
Q

IUS (Mirena): Advantages Mirena

A

Effective
Not user/intercourse dependent
Local hormone action

36
Q

IUS (Mirena): Mirena reduces

A

Periods (Heavy menstrual bleeding)

Risk endometrial cancer

37
Q

IUS (Mirena):Side effects Mirena

A

Irregular bleeding

38
Q

Oestrogen contraindications/cautions:

A
  1. Pregnancy
  2. Focal migraines
  3. VTE
  4. Breast cancer
39
Q

Non-hormonal methods:

A
  1. Intrauterine devices (coil)
  2. Barrier methods
    a. Condoms
    b. Diaphragms
    c. Caps
  3. Spermicides
  4. Natural methods
  5. Sterilisation

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