Brainscape's Knowledge GenomeTM

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


See full index

RED > L09 - Contraception & HRT > Flashcards

L09 - Contraception & HRT Flashcards

1
Q

Which contraceptive methods have the potential for user failure and which do not?

A
  • Methods without user failure = IUD, IUS, implant, sterilisation
  • Methods with user failure = barrier, hormonal, natural family planning & lactational amenorrhoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List 2 barrier methods other than condoms.

How are they used?

A

1 - Diaphragms

2 - Caps

  • They are inserted into the cervix and used in combination with spermicides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a LARC?

What are the advantages of LARCs?

A
  • Long-acting reversible contraception - a method that requires administration less than once per cycle/month

1 - Effectiveness doesn’t depend on memory or use

2 - More effective than other forms of contraception

3 - Cost-effective

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

What are intrauterine systems?

Describe the mechanism of action of intrauterine systems.

A
  • Intrauterine systems are small, plastic T-shaped devices that are inserted into the uterus
  • They gradually release levonorgestrel, a progesterone analogue. This causes:

1 - Thinning of the endometrium

2 - Thickening of the cervical mucus

3 - Inhibition of ovulation by negative feedback of FSH and LH

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

What are intrauterine devices?

Describe the mechanism of action of intrauterine devices.

A
  • Intrauterine devices are small, plastic T-shaped devices with copper on the stem / arms that are inserted into the uterus
  • They are directly toxic to both the sperm and the egg
  • If fertilisation occurs, they prevent implantation by inducing a foreign body reaction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the advantages and disadvantages of intrauterine systems?

A
  • Advantages: reduces menstrual bleeding / may induce amenorrhoea, reduced dysmenorrhoea, may reduce pain from endometriosis or adenomyosis
  • Disadvantages: pelvic exam & speculum to insert, hormonal s/e (headache, breast tenderness, acne), irregular bleeding (up to 9 months), benign ovarian cysts, no STI protection, expulsion <1:20
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the advantages and disadvantages of intrauterine devices?

A
  • Advantages: effective immediately, use as emergency contraception, non-hormonal
  • Disadvantages: pelvic exam & speculum to fit, may increase menstrual blood loss, may worsen dysmenorrhoea, no STI protection, expulsion <1:20
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the contraindications of intrauterine systems?

A

Pregnancy, >48hr or <4wk post-partum, post-partum sepsis, PID, gestational trophoblastic disease, cervical cancer, symptomatic STI cervicitis, pelvic TB, cardiac arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the contraindications of intrauterine devices?

A

Pregnancy, >48hr or <4wk post-partum, post-partum sepsis, PID, gestational trophoblastic disease, cervical cancer, symptomatic STI cervicitis, pelvic TB, cardiac arrhythmias, copper allergy, valvular heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the mechanism of action of implants.

A

They release etonogestrel, a progesterone analogue, to:

1 - Prevent ovulation by negative feedback of FSH and LH

2 - Thicken cervical mucus

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

What are the advantages and disadvantages of implants?

A
  • Advantages: highly effective, independent of intercourse, reduce HMB & dysmenorrhoea (may cause amenorrhoea), immediate return of fertility, may reduce risk endometrial cancer
  • Disadvantages: fitting & removal procedure, irregular bleeding, hormonal (headache, breast tenderness, mood changes), affected by enzyme inducers, no STI protection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the mechanism of action of injectable contraceptives.

A
  • Contain progesterone
  • Depo-Provera (150mg depo medoxy-progesterone acetate i.m. 12-14 weekly), Sayana Press (104mg s.c. 12-14 weekly), Norethisterone enanthate (200mg i.m. 8 weekly)
  • Action: inhibit ovulation, thicken cervical mucus, thin endometrium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the advantages and disadvantages of injectable contraceptives?

A
  • Advantages: highly effective, convenient, non-intercourse related, reversible, not affected by other medications, suitable for breastfeeding, reduces bleeding & pain, improved PMS, reduces severity of sickle cell crises in SCD
  • Disadvantages: once given, can’t be removed, menstrual irregularities, weight gain, no STI protection, may delay fertility return (up to 1yr), hormone effects, decrease bone mineral density long term (returns after stopping)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the mechanism of action of combined hormonal contraceptives.

A
  • Contain oestrogen and progesterone

- Action: prevent ovulation (primary), thickens cervical mucus, endometrial thinning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the advantages and disadvantages of combined hormonal contraceptives?

A
  • Advantages: regular, lighter, less painful periods, reduced risk ovarian/endometrial & colon cancer, may reduce premenstrual sx & improve acne
  • Disadvantages: ↑ risk thrombosis, MI, stroke, HTN, breast cancer (reduces w/ time after stopping), cervical cancer (with longer use), affected by enzyme inducers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the advantage of using a combined patch over combined pills?

A

Vomiting can affect pills, whereas combined patches are not affected by GI upsets

17
Q

Describe the mechanism of action of progestogen only pills.

A

Prevent ovulation (main action desogestrel POP), thicken cervical mucus, thin endometrium

18
Q

What are the advantages and disadvantages of progestogen only pills?

A
  • Advantages: effective, well-tolerated, reversible, less risk factors, can be used in breastfeeding & those that can’t use CHC, may improve PMS & reduce dysmenorrhoea & endometrial cancer risk
  • Disadvantages: menstrual irregularities, memory dependent, functional ovarian cysts, hormonal s/e (headaches, mood swings, depression, bloatedness, breast tenderness), no STI protection, ectopic risk if pregnancy occurs
19
Q

What are the contraindications of progestogen only pills?

A

Pregnancy, current breast cancer, decompensated liver disease & some malignant liver tumours, unexplained vaginal bleeding, undiagnosed breast conditions / past breast cancer, stroke, IHD, enzyme inducing drugs (rifampicin, griseofulvin, antiepileptics)

20
Q

What are the 3 main fertility indicators?

A

1 - Body temp

2 - Cervical secretions (mucus)

3 - Length of menstrual cycle

21
Q

What are the advantages and disadvantages of fertility awareness methods?

A
  • Advantages: awareness of fertility (avoid or plan for pregnancy), no physical s/e, avoids hormones/devices, acceptable to all faiths/cultures
  • Disadvantages: more reliable forms, may be considered messy/clinical, takes 3-6 cycles to learn effectively + daily records, time consuming, no STI protection, events (e.g. illness, stress or travel) may make indicators harder to interpret
22
Q

What are the criteria of the lactational amenorrhoea method?

A

For post-partum women:

  • Baby <6mths
  • Woman remains amenorrhoeic
  • Regular, exclusive breastfeeding
23
Q

How do male and female sterilisation methods work?

A
  • Male – vasectomy; permanent & irreversible on NHS; doesn’t affect sex drive or erections; ejaculation but no sperm; contraception for 8-12wks after so semen cleared; small infection risk
  • Female – tubal occlusion (Filshie clips or salpingectomy); permanent & irreversible on NHS; age not restriction
24
Q

What are the advantages and disadvantages of sterilisation?

A
  • Advantages: no need for further contraception, non-hormonal
  • Disadvantages: permanent, irreversible, higher failure rate than LARC
25
Q

What methods of emergency contraception are available?

A
  • Copper IUD = first line -> inserted up to 120hrs after first UPSI or within 5 days earliest expected ovulation; 99.9% efficacy; can be used for ongoing contraception or removed once pregnancy excluded
  • Levonorgestrel – efficacy up to 96hrs; 60% efficacy; can use multiple times per cycle; if vomiting within 2hrs, alternative method needed
  • Ulipristal acetate = EllaOne -> up to 120hrs after first UPSI / contraceptive failure; synthetic progesterone receptor modulator -> delays ovulation; prevents 60-80% expected pregnancies (significantly better than levonorgestrel); can be used multiple times per cycle

RED (13 decks)

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