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RED > L09: Contraception And HRT > Flashcards

L09: Contraception And HRT Flashcards

1
Q

What are the 3 main methods contraception aims to prevent pregnancy

A

1) Preventing ovulation
2) preventing fertilisation
3) preventing implantation of a fertilised egg

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2
Q

Does contraception include abortifacients

A

No

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3
Q

What happens to fertility as you age

A

Decrease

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4
Q

Is contraception 100% effective

A

No

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5
Q

What is the pearl index

A

Failure rate per 100 woman years of exposure

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6
Q

What is the typical use

A

Failure rate when used in real life e.g when patients forget to take the pill

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7
Q

What is the perfect use

A

The failure rate when method is consistent and correct at all time

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8
Q

What are the 2 broad categories of types of contraception

A

Methods with no user failure

Methods with user failure

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9
Q

What are the methods with no use failure

A

Intrauterine device IUD- copper
Intrauterine system- levonorgestrel hormonal coil
Implant: under the skin
Sterilisation (male and female)

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10
Q

What are the methods with user failure

A

Barrier: condones, diaphragm and cap
Hormonal: combined pill, patch, ring, POP injectable
Natural family planning and lactational ammenorhhea
Emergency contraception

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11
Q

What is the first of day of menstrual cycle

A

Day 1

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12
Q

What is the last day of menstrual cycle

A

Day 28

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13
Q

What happens to progesterone levels in the second half of menstrual cycle if there is pregnancy

A

Increases

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14
Q

What does the LH surge stimulate

A

Ovulation to kick off

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15
Q

What happen to oestrogen in the second half the cycle if there is pregnancy

A

Increases

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16
Q

What is new hormone is produced by the placenta that causes oestrogen and progesterone to rise

A

HCG

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17
Q

What are the barrier methods in males known as

A

Condom

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18
Q

Where is a condom places

A

Over an erect penis

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19
Q

What is the advantages of using a male condom

A

Protection against STI and HIV

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20
Q

What are barrier methods for females known as

A

Female condom
Diaphragm
Caps

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21
Q

Where is a female condom placed

A

Into the vagina which covers the lining of the vagina and partially the vulva

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22
Q

What is the advantage of using a female condom

A

STI and HIV protection

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23
Q

What do diaphragms and cap cover

A

Cervix

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24
Q

What has to be done to the diaphragm and cap after sexual intercourse

A

Left in for 6 hours after sex

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25
Q

What are the disadvantages of diaphragms and caps

A

Does not offer protection for STI and HIV

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26
Q

What can be used with diaphragm and caps

A

Spermicide

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27
Q

What are the risk of using a spermicide an diaphragm/cap

A

Increased risk of HIV transmission

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28
Q

What are the long acting reversible contraception methods

A

Intra uterine system- hormonal coil
Intra uterine device- copper coil
Implant
Progesterone only injection (POP)

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29
Q

What are the advantages of using long acting reversible contraception

A

Does not require memory
Is reversible
Administration is required less than once per cycle

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30
Q

What is the intra-uterine system

A

A coil that had levonorgestrel at the body

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31
Q

What hormone is levonorgestrel

A

Progesterone

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32
Q

What is the action of intra-uterine system

A

Thins endometrium
Thickens cervical mucus
Inhibit ovulation

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33
Q

What are the benefits of intra-uterine system

A

Reduce menstrual bleeding
Reduced painful bleeding
Reduce pain from endormetriosis

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34
Q

What are the disadvantages of intra-uterine system

A

Requires pelvic examination
Can lead to irregular bleeding up to 9 months
No STI protection
Benign ovarian cysts
Coils can become expelled: so patient has to feel for string

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35
Q

What are the contraindications of intra uterine system

A

Pregnancy
Post partum sepsis
Cardiac arrhythmias

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36
Q

What are the 4 types of intra-uterine system coils dependent on

A

Dosage of levonorgestrel

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37
Q

What is the intra uterine device

A

A t shaped coil that is made of copper

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38
Q

What is the mode of action of intra-uterine devices

A

The foreign body in the uterus prevents implantation

Copper is toxic to the egg and sperm

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39
Q

What are the advantage of intra uterine device i.e copper

A

Effective
Can be used as emergency contraception
Doesn’t involve hormones which some women will be sensitive to

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40
Q

What are the disadvantages of intra-uterine device

A 
Requires pelvic examination 
May increase menstrual bleeding 
Painful periods 
No STI protection 
Risk of ectopic pregnancy if pregnancy occurs
41
Q

What are the contraindication of intra uterine device

A

Same as IUS

42
Q

What are implants

A

A device that sits under the skin in the harm

43
Q

What hormone does implants contain

A

Etonogestrel

44
Q

What is the duration of use of implants

A

3 years

45
Q

What is the mode of action of implants

A

Inhibit ovulation

Thicken cervical mucus

46
Q

What hormone is etonogestrel

A

Progesterone

47
Q

What are the advantages of implants

A

Reduces heavy bleeding
Reduces painful bleeding
May reduce endometrial cancer

48
Q

What are the disadvantages of implants

A

No protection for STI
Hormonal side effects
Irregular bleeding
Affected by enzyme inducer medication

49
Q

What are the mode of action of progesterone only injectable

A

Inhibit ovulation
Thickens cervical mucus
Thins endometrium

50
Q

What are the advantages of injectable

A

Reducing bleeding and pains

Reduces sickle cell crises if sickle cell disease

51
Q

What are the disadvantages of injectable

A 
No STI protection 
Irregular bleeding 
Delayed fertility up to 1 year 
Hormonal side effects 
Decreases bone mineral density (for 55+)
52
Q

What hormones does combined hormonal contraceptive pill contain

A

Oestrogen

Progesterone

53
Q

What forms can combined hormonal contraception be found in

A

Pill
Patch
Vaginal ring

54
Q

What is the mode of action of combined hormonal contraception

A

Prevent ovulation
Thicken cervical mucus
Thin endometrium

55
Q

What are the benefits of combined hormonal contraception

A

Gives regular bleeeding, lighter and less painful
Reduces pre-menstrual symptoms
Reduces ovarian cancer risk
Improve acne

56
Q

What are the disadvantages of combined hormonal contraception.

A 
Venous or arterial thrombosis 
Heart attack 
Breast cancer 
Cervical cancer 
Hypertension 
No STI protection
57
Q

What is the effectives of combined hormonal contraception affected by

A

Enzyme inducers

58
Q

What is the standard use regime to use combine hormonal contraception

A

Use 21 days with 7 days break (where you get the withdrawal bleed)

59
Q

What is the combined hormonal contraception patch called

A

Evra

60
Q

How many patches do you use for 1 week for 3 weeks

A

1

61
Q

What is the brand for combined vaginal ring known as

A

Nuvaring

62
Q

What is the oestrogen in the combined hormonal contraception called

A

Ethinyl estradiol

63
Q

What is the progesteron only pill (pop)

A

A pill that contain progesterone only

64
Q

What is the mode of action of pop

A

Prevent ovulation
Thin endometrium
Thicken cervical mucus

65
Q

How long does it take for a pop to be effective

A

2 days

66
Q

What are the benefits of pop

A

Can be used in breastfeeding

67
Q

What drugs can pop not be used with

A

Enzyme induce drug

68
Q

What are the disadvantages of pop

A

Hormonal side effects
No STI protection
Change periods
Memory dependent

69
Q

What are the 2 natural family planing methods

A

Fertility awareness method

Lactational ammenorhhea

70
Q

What is fertility awareness method about

A

Working out when you are the most fertile by looking at the indicators

71
Q

What are the main fertility indicators

A

Basal body temperature
Cervical secretions
Length of menstrual cycle

72
Q

When can you only use the fertility awareness methods

A

If you have a regular period

73
Q

What are the disadvantages of fertility awareness method

A

Time consuming

Events such as illness can change indicators such as body temperature

74
Q

What is lactational ammenorhhea for

A

Post partum women

75
Q

What are the criteria’s needed for lactational amennorhea

A

Baby less than 6 months old
Women has remained ammenorhoic
Need to be regularly breastfeeding : every 4 hours and 6 hours at night
Have to breast feeding only : should not involve bottles

76
Q

How many of the criteria’s should be met

A

All

77
Q

What are the 2 types of sterilisation

A

Male sterilisation

Female sterilisation

78
Q

What does male sterilisation involve

A

Cut and tie the vas deferens

79
Q

What does the female sterilisation involve

A

Clipping the Fallopian tube

80
Q

What are the disadvantages of sterilisation

A

Risk of regret as it is permanent

81
Q

What is required for people wanting sterilisation

A

Counselling so they know the disadvantages

82
Q

What are the 2 main categories of emergency contraception

A

Copper iud

Hormonal

83
Q

What are the 2 hormonal pills used in emergency contraception

A 
Levonorgestrel 
Ulipristal acetate (Ella one)
84
Q

When can levonorgestrel be used

A

Up to 96 hours

85
Q

When can ulipristal acetate (Ella one) be used

A

5 days

86
Q

What is the definition of menopause for patients over the age of 45

A

Ammenorhhea for at least 12 months with no other cause

87
Q

What is the definition of menopause for people under the age of 45

A

Amennorhea for at least 24 months with no other cause

88
Q

Which hormonal emergency contraception is the most effective

A

Ella one

89
Q

Why do we have symptoms in menopause as a result of

A

Low oestrogen

Low progesterone

90
Q

What are the menopausal symptoms

A 
Loss of libido
Mood change
Hot flushes
Vaginal dryness 
Fatigue
91
Q

What are the long term effects of oestrogen deficiency

A

Increased risk of mi

Osteoporosis

92
Q

What treatment is offered to women with menopause symptoms

A

Hormonal replacement therapy

93
Q

What are the types of hormonal replacement therapy

A

Combine (oestrogen and progesterone)

Oestrogen only

94
Q

Who can receive eostrogen only

A

Woman with no uterus

95
Q

What are the risk of hormonal replacement therapy

A

Increased risk of breast cancer

96
Q

How does using spermicide increase the risk of STI

A

Spermicide can irritate the vagina and make it easier for STD germs to enter the body

97
Q

Up to how many days can copper IUD be inserted after unprotected sexual intercourse

A

5 days after UPSI

98
Q

Up to how many days can you insert the copper IUD after the earliest estimated ovulation

A

5 days therefore if the average cycle is 28 days at 14 days ovulation occurs, + 5 days= 19 day. Therefore at day 19 it can be inserted.

RED (19 decks)

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