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Contraception Y4 > Progesterone only hormonal > Flashcards

Progesterone only hormonal Flashcards

1
Q

Can progesterone-only contraceptive pill (POCP) be used in breastfeeding?

A

Yes. It can also be used in hypertension (unlike COCP)

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2
Q

(5) names of Progesterone-only contraceptive pills (POCP)

A
  • Femulen® – etynodiol diacetate
  • Norgeston® – levonorgestrel
  • Noriday® – norethisterone
  • Micronor® – norethisterone
  • Cerazette® – desogestrel
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3
Q

MoA of progesterone-only contraceptive pill (POCP)

A
  • thickens cervical mucus →due to high progesterone levels → entry of sperm is prevented
  • suppress ovulation / inhibit ovulation (depends on the substance used in a pill)
  • thinning of the endometrium → so implantation is prevented
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4
Q

Advantages of use of progesterone-only pill

A
  • More effective than barrier methods when taken correctly
  • Sex doesn’t need to be interrupted to use contraception.
  • Can be used in many patients for whom the combined oral contraceptive is contraindicated.
  • May reduce risk of endometrial cancer
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5
Q

Disadvantages of progesterone-only pills use

A
  • user dependent → need to be taken correctly
  • can produce irregular menstruations or amenorrhoea
  • SEs when pills are first started: headaches, skin changes, breast tenderness
  • increased risk of ovarian cysts
  • small increase in risk of breast cancer
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6
Q

Contraindications for POCPs

A
  • current or past Hx of breast cancer
  • liver cirrhosis or tumour
  • lower efficiency in women over 70kg
  • stroke or coronary heart disease
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7
Q

What is the name of only one progesterone-only implant licensed in the UK?

A

Nexplanon

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8
Q

How big is progesterone only implant and ho long does it last for?

A
  • 40 mm long
  • contains 68mg of etonogestrel (steroidal progestin) →released into systemic circulation for 3 years
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9
Q

Mechanism of action of Nexplanon (implant)

A
  • inhibits ovulation
  • thickening of cervical mucus (sperm cannot pass)
  • thinning of the endometrium (due to high progesterone level) →prevent implantation if an egg is to be fertilised
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10
Q

Advantages of the progesterone-only implant (Nexplanon)

A
  • extremely effective
  • can be used in those for whom COCP is contraindicated
  • no need to think about contraception for 3 years
  • can be used while breastfeeding
  • normal fertility returns as soon as the implant is removed
  • effective in women of all BMIs → although in high BMI, an earlier replacement of implant is recommended
  • may reduce risk of endometrial cancer
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11
Q

Disadvantages of Nexplanon (progesterone-only implant)

A
  • irregular bleeding patterns in 50% of women
  • procedure required to fit and to remove the implant → pain, irritation and bruising
  • small increase in risk of breast cancer
  • implant can sometimes break/bend when in situ
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12
Q

Contraindications to Nexplanon (progesterone-only implant)

A
  • pregnancy
  • unexplained vaginal bleeding
  • liver cirrhosis or tumour
  • Hx of breast cancer
  • stroke or TIA while using an implant
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13
Q

(3) names of progesterone-only injectable contraceptives

A
  • Depo-Provera®
  • SAYANA PRESS®
  • Noristerat®
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14
Q

How long for and how is administrated Depo-Provera?

A

Depo-Provera (progesterone-only injectable)

  • deep IM injection
  • given every 12 weeks

*Depo-Provera is most commonly used progesterone-only injectable

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15
Q

How long for a is Sayanna-Press administrated for?

A

SAYANNA -PRESS = injectable progesterone- only

  • injections given every 12 weeks
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16
Q

What’s Noristerat?

  • route of administration
  • how often must be administrated
A

Noristerat = injectable progesterone-only

  • deep IM injection
  • every 8 weeks

*rarely used as licensed only to use for short term use (to sets of injections)

17
Q

MoA of progesterone-only injectables

A
  • inhibit ovulation
  • thickens cervical mucus
  • thinning of endometrial lining (so if an egg becomes fertilised it will be difficult for it implant)
18
Q

Advantages of injectables progesterone-only

A
  • very effective
  • users do not need to think about contraception for as long as the injection last
  • not known interaction with any drug
  • it can be used when COCP is contraindicated (e.g. migraine, breastfeeding)
  • can be used in women with BMI <35
  • may reduce risk of endometrial cancer
19
Q

Disadvantages of progesterone-only injectibles

A
  • not readily reversible → can take up to a year for normal fertility and menstruation to return
  • altered bleeding patterns (including persistent bleeding)
  • increase in body weight (up to 2-3 kg over a year)
  • slightly increased risk of breast cancer
  • loss of bone mineral density in long-term use (over a year) *but no evidence that increases risk of fractures
20
Q

Contraindication of progesterone-only injectibles

A
  • current cancer or present within the last 5 years
  • Hx of severe arterial disease or very high risk factors
  • pregnancy
  • diabetes with any vascular disease (e.g. retinopathy)
  • people who will want to return their fertility in a near future

Contraception Y4 (8 decks)

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