Lecture 19 - contraception

Question 1

Natural methods of contraception

Answer 1

Temp increase- 3 days after temp increase (due to progesterone increase) you are infertile - must be measured exact same time every day

Mucus - sign of fertile mucous - is increase in volume and is thinner
-infertile on fourth evening after peak mucus day

Cervix
-at ovulation - peak height from introitus, maximum softness

When does ovulation occur
-luteal phase - fixed

Question 2

Combined oral contraceptive pill

Answer 2

Given pill for 3 months initially,

• low dose pill - has 2nd generation progesterone and estrogen - has lowest DVT risk
• higher level of pill - enzyme inducers can interact with the pill
• if miss 2 pills, also vomit or dihorea then not protected
• 7 day rule
• pill will suppress ovulation - stop hormone supply from ovaries

Question 3

Emergency contraceptive pill

Answer 3

• levonorgestrel
• take within 72 hours of unprotected sex
• no effect if given after ovulation
• good efficacy
• doesn’t work if large BMI

Question 4

IUD

Answer 4

Post coital IUD - insert within 5 days of ovulation

-will work

Question 5

What is a contraceptive

Answer 5

stops sperm and egg meeting up
-progesterone only pill - thickens mucous and stops sperm getting in
-

Question 6

High dose estrogen

Depo Provera - injection

Answer 6

high dose estrogen injection
works same as combined pill - stops ovulation
-go every 12 months

Question 7

Copper IUD

Answer 7

TO be used as contraceptive

• spermacide - kills this - cannot get past IUD to meet egg
• can stay in for 10 years
• if have claymida before - then bad
• need to make sure you tell patient that they do not prevent STIs

-main side - copper IUD - can make longer periods more cramping - give mirena

Question 8

mirena

Answer 8

-had lenogesterol/progesterone
-can take away period pain, and make them lighter
-only subsitdised for people with heavey menstrual periods
-

Question 9

contraceptive implants

Answer 9

• can work for a few years
• prevent ovulation in most cycles
• good for dysmennohrea
• not effective with enzyme induces
• may get spotting in-between

Question 10

Nuva Ring

Answer 10

stops ovulation

• vaginal ring - estrogen and progesterone ring - similar to combined pill
• 3 weeks in 1 week out
• enzyme inducers are bad