Lecture 18 - Contraception Flashcards
Contraception definition?
a method of preventing pregnancy via interference with ovulation, fertilisation or implantation
Perfect contraceptive?
100%: effective, convinient, reversible, safe; with extra benefits, cheap and acceptable
Key target of contraception?
the LH surge leading to ovulation
UK MEC criteria?
1->4: no restriction, advantages outweigh disadvantages, vice versa, do not use
OCP uses?
suppress ovulation, reduce sperm transport, implantation inhibition, thicken cervical mucus
The pill free interval?
pointless, potentially wake sleeping ovaries, 3-4 day interval reduces FSH climb which is linked to LH surge`
History/screening for OCP?
timing, menstrual cycle, family hx focal migraines, smoking, wight, BP, interactions
Progesterone only pill?
thicken cervical mucus, maximal 48hr after start
Why/why not use POP?
contraindication to oestrogen or are breastfeeding; small window of opportuniy due to relying on cervical mucus, Cerazette is unfunded but suppresses ovulation
The jab?
Depo-Provera, 12 weekly that is oestrogen free, suppress ovulation and thicken cervical mucus, side effects prolonged amenorrhea, weight gain and delayed return of fertility
The rod?
Jadelle, few contraindications, high satisfaction, main side risk bleeding
Rod functions?
alters endometrium to prevent implantation, thickens cervical mucus, prevents ovulation
Copper IUD?
reversible, up to 10yr, kills sperm, inflammation to prevent implantation, 99.9% efficiency, side effects flow and pain increase in periods
Myths busted about IUD?
introduces infection, not for nullips, contraindication of pervious ectopic pregnancy, they get lost
Mirena IUS?
unfavourable environment to sperm, makes endometrium thinner, thickens cervical mucus
Prescribing IUS?
diagnosis of menorrrhagia, low ferritin and heamoglobin, hormone replacement therapy
Emergency Contraceptive pill?
85% efficacy @ 72hr, postpones ovulation by 5 days
