Gynaecology - Fertility regulation Flashcards
Methods of contraception
Contraceptive history
Periodic abstinence
Method
Monitoring
Periodic abstinence
Advantages
Disadvantages
Coitus interruptus
Disadvantage
Lactational amenorrhea
Efficacy
Disadvantages
Barrier method contraceptives
Spermicide is indicated for low risk high age women switching off COCP
Spermicides
Preparations
Performance
Disadvantgaes
Barrier method
Advantages and disadvantages
Hormonal contraceptives
Options
Hormonal contraceptives
Advantages and disadvantage
COCP
Preparations
MoA
COCP
Contraindications
COCP
Advantages
COCP
Disadvantages
COCP
Instructions
COCP
Missed pill management
Progestin only pill
Preparation
MoA
Advantages and disadvantages
POP is suitable for use/ switch from COCP after age 50
Cut-off for COCP use is 50 years old due to increased cardiovascular risk
POP has minimal effect on BMD compared to POI
POI has more weight gain compared to negligible difference in COCP
Injectable hormones
Advantages and disadvantages
Expect about 2 years of irregular bleeding before amenorrhea
Newer forms of hormonal contraceptives
Copper IUCD
MoA
Duration
S/E
Levonorgestrel-releasing IUCD
MoA
Duration
S/E
IUCD
Advantages and disadvantage
IUCD
Contraindications
Emergency contraception
Use
Regimens
Regimens of hormonal method:
- Yuzpe regimen: ethinyl estradiol 100μg + levonorgestrel 0.5mg (or norgestrel 1mg) for 2 doses 12h apart
- levonorgestrel-only: levonorgestrel 1.5mg (Anlitin) single dose
- progestogen receptor modulator: ulipristal acetate 30mg (ellaOne)
Copper IUCD: may prevent implantation
- can be used within 5d of unprotected sexual intercourse (UPSI) (same as ulipristal → often use it instead)
- very effective – failure rate <0.1%
- can be continued for long-term contraception
Emergency contraceptive
Compare effective time and effectiveness
Sterilization
Risk factors for later regret
Female sterilization
Procedure
Risks
Male sterilization
Procedure
Risks
