Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Kirsty - Y3S2 > IPP: Contraceptive methods > Flashcards

IPP: Contraceptive methods Flashcards

1
Q

How does the COC work and what is examples?

A

Primarily inhibits ovulation:

  • Progesterone and Oestrogen act on the hypothalamus pituitary axis to inhibit release of FSH and LH.
    • No surge of LH and FSH to stimulate the ovaries so ovulation does not occur.
  • Also effects cervical mucus and endometrium:
    • Progesterone causes thickening of cervical mucus preventing sperm entry and prevents hyperplasia of the endometrium by opposing the proliferative effects of oestrogen
  • The oestrogen component of the CC causes the endometrium to proliferate and grow.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the effectiveness of the COC

A
  • Use: 92%
  • Theoretical: 99.7%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the advantages of the COC

A
  • Makes period lighter, shorter and pain-free
  • Reduces risk of 3 types of cancer by 50%
  • More effective than barrier methods
  • Sexual intercourse doesn’t need to be interrupted
  • Reduced acne in some women
  • Normal fertility returns immediately after stopping
  • Reduce risk of benign breast disease, osteoporosis, corectal cancer and of functional ovarian cysts and benign ovarian tumours
  • Reliable and reversible
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Disadvantages of COC

A
  • Replies on patient remembering to take them
  • Doesn’t protect against STIs – use condom too.
  • Less effective than Long-acting reversible methods
  • Some women experience temporary adverse effects when they start COCs (nausea, abdo pain, headache, breast-tenderness and mensutational irreg)
  • Only used in certain groups of women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Legal Framework for supply for COCs

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does the POP work?

Examples?

A
  • Aka mini-pill: Levonorgestrel, Desogestrel, norethisterone

5 independent mechanisms of action:

  • Suppression of ovulation
  • Suppression of mid-cycle peaks of LH and FSH
  • Production of ‘hostile, blocked’ mucus resulting in poor sperm penetration
  • Reduction in the number and size of endometrial glands and inhabitation of progesterone receptor synthesis in the endometrium, preventing implantation.
  • Reduction in the activity of cilia in the Fallopian tube
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Effectiveness of the POP

A
  • Use: 92%
  • Theoretical: 99.7%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Advantages of POP

A
  • More effective than barrier methods (when correctly taken)
  • Sex not interrupted
  • Used when COC not suitable
  • Reduce risk of endometrial cancer
  • Normal fertility returns when POP stopped
  • Desogestrel may be beneficial in managing dysmenorrhoea.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Disadvantages of POP

A
  • Replies on patient remembering to take them
  • Pills must be taken at the same time each day, or within 3 hours, except for the desogestrel-only pill, which must be taken within 12 hours to be effective.
  • Doesn’t protect against STIs – use condom too.
  • Temporary adverse effects when start POPs (unscheduled bleeding, breast tenderness)
  • Only used in certain groups of women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Legal framework for POPs

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does the contraceptive patch work?

Example?

A

Ortho Evra contraceptive patch

Same mechanism as POP:

5 independent mechanisms of action:

  • Suppression of ovulation
  • Suppression of mid-cycle peaks of LH and FSH
  • Production of ‘hostile, blocked’ mucus resulting in poor sperm penetration
  • Reduction in the number and size of endometrial glands and inhabitation of progesterone receptor synthesis in the endometrium, preventing implantation.
  • Reduction in the activity of cilia in the Fallopian tube
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Effectiveness of the progesterone patch?

A
  • Use: 92%
  • Theoretical: 99.7%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Advantages of the patch?

A
  • Applied weekly so more convenient that pill everyday
  • Patches do not become less effective if vomit or diarrhoea
  • Patch as effective as COCs
  • Doesnt interupt sex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Disadvantages of the patch

A
  • It can be seen
  • Can become partially or completely detached compromising efficacy
  • Less effective if >90kg
  • Risks and adverse effects e.g. skin irritation, nausea, vomiting and unscheduled bleeding
  • Delay in returning to normal fertility after stopping – up to few months
  • Doesn’t protect against STIs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Legal framework for the patch

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does the progesterone only injection work?

How often is it given?

Examples

A

Depot medroxyprogesterone acetate (Depo Provera® and Sayana Press®) or norethisterone enantate (Noristerat®)

  • Given once every 3 months
  • Inhibit ovulation and thicken cervical mucus, therby presenting a barrier for sperm pentetration.
  • Also changes endometrium environment making it unfavourable to sperm.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Effectiveness of the progesterone only injection?

A
  • Use: 97%
  • Theoretical: 99.5%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Advantages of the progesterone only injection?

A
  • Can make periods disappear all together
  • It is very effective
  • Users do not have to think about contraception for as long as the injection lasts — 12 weeks for DMPA and 8 weeks for NET-EN.
  • Sex not interrupted
  • Used when breastfeeding
  • No known interactions with medicine
  • Can reduce heacy periods with premenstrual symptoms
  • Used where COCs not recommended
  • Still used if BMI >35kg/m2
  • Reduce risk of ovarian and endometrial cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Disadvantages of progesterone only injection?

A
  • It is not rapidly reversible. After stopping use of progestogen-only injectables: There could be a delay of up to 1 year in the return of normal fertility.
  • Menstruation can take several months to return to normal.
  • Doesn’t protect from STIs
  • Adverse effects including unscheduled bleeding and weight changes may occur.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Legal Framework for progesterone injection

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does the implant work?

Examples?

What is it?

A
  • Nexplanon (etonogestrel)
  • 4cm tube filled with progesterone inserted sub dermally into the upper arm.
  • Once removed immediately use another contraceptive to avoid getting pregnant
  • Works by inhibiting ovulation and also causes change in cervical mucus that inhibits sperm entry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Effectivness of the implant?

A
  • Use: >99%
  • Theoretical: >99%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Advantages of the implant

A
  • Don’t have to remember to take tablet every day
  • Lasts 3 years and
  • Can be removed at any point.
  • Fertility returns as soon as removed
  • Implant very effective
  • Sex not interrupted
  • Can be used when breastfeeding
  • Used in women who COCs not recommended
  • It may help alleviate dysmenorrhoea.
  • Not associated with many serious adverse side effects: There is little or no increased risk of venous thromboembolism, stoke, or myocardial infarction. It does not significantly adversely affect bone mineral density
  • Effective in all weights
24
Q

Disadvantages of the implant

A
  • About 50% of women will experience changes in menstrual bleeding, and bleeding patterns are likely to remain irregular.
  • Doesn’t protect against STI
  • Effectiveness reduced in using liver enzyme-inducing drugs
25
Q

The intra-uterine progesterone only system (IUS) - how does this work?

A
  • Intraurterine device fitted into the ureteine cavity and contains progesterone release over 5 years.
  • Fetility restarts after a month of stopping
  • progestogenic effects on the endometrium, prevents implantation of the fertilized ovum.
  • Changes in cervical mucus also inhibit penetration of sperm into the uterus.
26
Q

Effectiveness of IUS

A
  • Use: >99%
  • Theoretical: >99%
27
Q

Advantages of IUS

A
  • Makes periods light, shorter and less painful
  • Long-term 3-5 years
  • Suitable for all women of all age groups
  • Easy and simple to fit. Once In aren’t aware
  • Very safe and effective
  • Sex not interrupted
  • Normal fertility returns as soon as removed
28
Q

Disadvantages of IUS

A
  • Doesn’t protect against STIs
  • Internal pelvicexamination needed to check suitable and to insert the device.
  • Might be pain or discomfort for a few hours after insertion; this can be treated with analgesics such as paracetamol or ibuprofen.
  • Trained healthcare provider needed to remove device.
  • Maybe expelled without knowing
  • Adverse effects: heading, acne, unscheduled bleeding during first 3-6 months.
29
Q

Legal framework for IUS

A
30
Q

Describe how male condoms work

Examples

A

Barrier – prevent sperm entry into the uterus

Latex and non-latex

31
Q

What is the effectivness of the male condom?

A
  • Use: 85%
  • Theoretical: 98%
32
Q

Advantages of male condoms?

A
  • Easy to use and obtain
  • Effective if used correctly
  • Protect against STIs
  • May protect against cervical cancer
  • Adverse effects rare
33
Q

Disadvantages of male condom

A
  • Forward planning and interrupt sex
  • Requires participation of both partners
  • Careful disposal
  • Less effective than hormonal or intrauterine methods. Can break or slip off.
  • Loss of sensitivity during sex
  • Allergy to latex
34
Q

How does the female condom work?

Examples

A

Barrier – prevent sperm entry into the uterus

Femidom

35
Q

Effectiveness of the female condom

A
  • Use: 79%
  • Theoretical: 95%
36
Q

Advantages of the female condom?

A
  • Reduce risk of STI
  • Protect against cervical cancer
  • Less likely to tear
  • No known adverse effects
37
Q

Disadvantages of female condom

A
  • Require careful insertion
  • Require motivation at each act of intercourse.
  • Can be dislodged, or the penis can be inserted between the vaginal wall and the female condom.
  • Can be noisy during intercourse.
  • May cause discomfort during sex due to the inner ring.
  • Are not as effective at preventing pregnancy as hormonal and intrauterine methods.
38
Q

How does the diaphragm work?

Examples

A
  • Coiled spring diaphragm
  • Arcing spring diaphragm
  • Placed inside vagina prior to intercourse with some spermicide.
  • Barrier and toxic to sperm
39
Q

Effectiveness of the diaphragm

A
  • Use: 84%
  • Theoretical: 94%
40
Q

Advantages of the diaphragm?

A
  • Adverse effects are rare.
  • They can be inserted at a convenient time (up to 3 hours) before intercourse, so that spontaneity can be maintained.
  • The woman can control the use of contraception.
  • These methods are not compromised by concurrent drug therapy (for example liver enzyme-inducing drugs).
41
Q

Disadvantages of the diagrapm?

A
  • Not as effective as hormonal or IU methods
  • Require planning
  • Must be left in place for at least 6hr after sex
  • Fit needs to be checked after weight gain/ loss >3kg or after birth
  • UTIs can occur
  • May not reduce STI risk
  • Spermicide can cause allergy or irritation
42
Q

Legal framework for the diaphragm?

A
43
Q

How do intra-uterine devices work?

Example?

A
  • TT380 slimline
  • Copper T380A
  • Copper acts as a spermicide as toxic effects on sperm and ovum – prevents fertilisation.

In addition, alterations in the copper content of cervical mucus may inhibit penetration by sperm, and inflammatory reactions within the endometrium may prevent implantation, should the ovum be fertilized. Consequently, the Cu-IUD can work immediately after insertion.

44
Q

Effectiveness of IUD?

A
  • Use: >99%
  • Theoretical:>99%
45
Q
A
46
Q

Advantages of IUD

A
  • Lasts 10 years
  • Reduces risk of endometrial cancer by 50%
  • Suitable for all women of all age groups
  • Very safe and effective
  • Effective immediately after insertion
  • Long-term 5-10 years
  • Sex not interrupted
  • Immediately reversible – fertility returns immediately
  • Used when breastfeeding
  • No drug interactions
  • Reduced risk of endometrial and cervical cancer
47
Q

Disadvantages of IUD

A
  • Makes periods slightly heavier and longer
  • Internal pelvic examination needed to check suitable and to insert the device.
  • Might be pain or discomfort for a few hours after insertion; this can be treated with analgesics such as paracetamol or ibuprofen.
  • Some women have severe cramps 3-5 days after insertion
  • No protective against STI
  • Can’t discontinue use on own
  • Adverse effects: Unschedules bleeding (3-6 months)
  • Spotting may occur after insertion but resolve in day or so
48
Q

Describe the use of neutral methods?

Examples?

A

Fertility awareness methods or Lactational amenorrhoea methods

Monitoring:

  • Cervical secretions, palpating cervix, BBT, length of menstrual cycle
  • Dipsticks
49
Q

Effectiveness

A

Fertility Awareness method:

  • Use: 75%
  • Theoretical: 95-97%
50
Q

Advantages of fertility awareness method?

A
  • Can be used by most couples
  • Doesn’t require chemical or physical products
  • No CI
  • Acceptable to all cultures
  • Immediately reversible
51
Q

Disadvantages of natural methods?

A
  • Less effective
  • Require commitment and cooperation of both partners
  • Not suitable if irregular cycles
  • Doesn’t protect against STIs
52
Q

How does sterilisation work?

Examples?

A

Vasectomy or tubal occlusion

The operation to sterilize a man is vasectomy.

The operation to sterilize a woman is tubal occlusion.

53
Q

Effectiveness of sterilisaion

A

Tubal ligation:

Use: 99.5%

Theoretical: 99.5%

Vasectomy:

Use: 99.85%

Theoretical: 99.9%

54
Q

Advantages of sterilisation?

A

Both:

  • Very effective
  • Permanent
  • Sex not interrupted
55
Q

Disadvantages of sterilisation?

A
  • Vasectomy:
  • Requires minor surgical procedure – small risk of haematoma and infection
  • 12 week additional contraception required
  • May regret – cannot be easily reversed
  • Does not protect against STIs
  • Tubal occlusion:
  • May regret – not easily reversed
  • Surgical procedure required
  • Not protect against STIs
  • Can fail but common
  • See NICE guielines

Kirsty - Y3S2 (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions