Lecture 7 - Contraception and HRT Flashcards
What is effectiveness in terms of contraception and how is it measured?
Effectiveness is a measurement of failure in contraception. It is measured using the pearl index, a score of 4 means that 4 in 100 women using it will be pregnant by the end of the year.
What are some features of an ideal contraceptive?
100% safe 100% effective Independent of intercourse Reversible cheap simple and painless
Which part of the menstrual cycle is constant and which part can vary in length?
The length from ovulation to menstruation is always 14 days whereas the time before ovulation (follicular phase) can vary in length.
What are the main types of contraception?
Hormonal - COC, POP etc. Intrauterine - copper coil, Mirena Barrier - condoms Natural methods - family planning Sterilisation
What are the three main methods of natural family planning?
Rhythm method - have sex around the time of ovulation
Billing’s method - uses changes in cervical mucus, thick and sticky during luteal phase
Lactational ammenhorrea
What are the types of Hormonal contraceptives?
Combined hormonal contraceptives e.g. pills, patch
Progesterone only contraceptives e.g. progesterone only pill
Long acting reversible contraceptives e.g. injectables, intrauterine, implants
What is the mechanism of action of combined hormonal contraceptives?
They cause negative feedback to HPO axis so prevent ovulation.
What are the side effects of combined oral contraceptive?
Headaches, weight gain, breast tenderness.
What are the disadvantages of the combined oral contraceptive?
Small increase in breast cancer risk, circulatory disease and venous thromboembolism risk
What are the evra patch and Nuva ring?
Both combined oral contraceptives. transdermal patch and vaginal ring.
What are the disadvantages of the progesterone only pill?
It can cause menstrual irregularities, ectopic pregnancy and functional ovarian cysts.
What is the injectable contraceptives?
Same as progesterone only pill
How do implants work?
They inhibit ovulation through production of etonogestrel which is a steriodal progestin
How does the mirena coil work?
Prevents ovulation through release of levonorgestrel which is a steroid.
How does the intrauterine device (copper coil) work?
It is spermicidal and also stops the embryo from implanting. This is due to a foreign body type reaction.
What are the three main types of emergency contraception?
Levonelle one step is progesterone only (nausea and vomiting).
EllaOne is synthetic progesterone receptor modulator (not as effective but less side effects)
IUD (copper coil) can be inserted up to 5 days after intercourse to prevent implantation.
before how many weeks can you have an abortion?
24 (6 months) if section 1
What is the result of oestrogen deficiency after menopause?
It causes osteoporosis, alzheimers and increased insulin release.
Why must unapposed oestrogen not be given to women with a uterus and what must be given instead?
It causes endometrial hyperplasia and cancer. Instead must be given combined HRT (oestrogen and progesterone).
What is the disadvatage of the combined HRT?
This slightly increases the risk of breast cancer, whereas oestrogen only does not
