Fertility control Flashcards
What is combined oral contraceptive, what is their action and side effects?
mixture of oestrogen + progestogen.
Progestogen inhibits ovulation by suppression of LH surge, thickens cervical mucus + renders endometrium ‘hostile’. oestrogen prevents follicular development by suppression of FSH.enterohepatic (re)circulation.
Nausea, vomiting, abdominal cramps, fluid retention, changes in body weight, hepatic impairment. cardiovascular changes - DVT, breast tenderness, cervical erosion. exacerbation of migraine. Chloasma. Mood changes.
Combined hormonal contraceptives are available in which forms?
tablets (COC - combined oral contraceptive)
transdermal patches (CTP - combined transdermal patch)
implants
vaginal rings (CVR - contraceptive vaginal ring).
highly user-dependent methods with failure rate of < 1% if used correctly.
Which factors may contribute to contraceptive failure?
weight,malabsorption (COC only), drug interactions
How does the progesterone- pill (POP) work?
Alters cervical mucus to prevent sperm penetration, may inhibit ovulation in some women. offers suitable alternative to CHCwhen oestrogens are contra-indicated (e.g. venous thrombosis, heavy smokers, hypertension, valvular heart disease, diabetes mellitus with complications + migraine with aura).
What is the action and adverse effects of the progesterone-only pill?
inhibit ovulation by suppression of LH surge, thicken cervical mucus and render endometrium ‘hostile’ enterohepatic (re)circulation.
menstrual irregularity, nausea, vomiting, headache. Breast discomfort, weight changes, changes in libido.
Give examples of long-active reversible contraceptive (LARC)methods
contraceptive implant, intrauterine system (IUS), intrauterine device (IUD)
Which drugs may interfere with CHC?
enzyme-inducing drugs, lamotrigine, rifampicin
What are the emergency ‘morning after’ contraceptions and which drug induces an abortion?
levo-norgestrel, ulipristal, IUD/IUS.
mifepristone
What should be monitored for infertile women?
TSH as thyroid function plays an important role in functional ovarian reserve
How does oestrogen and progesterone affect TH?
increases plasma protein concentration of thyroid hormone, while free hormone concentrations remain stable
What is speculated to to be essential for normal neurological maturation of the foetus before foetal thyroid becomes functional?
maternal thyroxine (T4) and thyroid hormone
What is the mechanism of action of male hormone contraceptives?
near-complete and reversible suppression of spermatogenesis
What are the most common adverse effects of male hormonal contraceptives?
frequencies of mild to moderate mood disorders were relatively high, acne, injection site pain, increased libido
