Sexual and Reproductive Health 2 Flashcards
What are the two different types of morning after pill?
levonella
ulipristal (ellaOne)
How does levonellse work?
single 1.5 mg dose of progesterone
best taken within 24 hours and no later than 72 hours
affects sperm function, endometrial receptivity and prevents follicular rupture
vomiting and menstrual disturbances in following cycle
How does Ulipristal work?
selective progesterone receptor modulator
prevents/delays ovulation, reduces embryo implantation
as effective as levonelle can be used up to 120 hours
blocks action of progesterone therefore reduces the effectiveness of progesterone containing contraceptives
How can the IUD be used as emergency contraception?
Insertion of IUD usually prevents implantation
Can be inserted up to 5 days after unprotected intercourse or expected day of ovulation
Antibiotic prophylaxis given at time of insertion
What are the causes for failure to use adequate contraception?
major problem
contraception must be appropriate to woman’s lifestyle
misunderstandings and dislikes lead to non-compliance
fully counsel woman on major problems and minor Res
What are the failure rates of the different types of contraception?
Combined oral contraceptive pill/combined transdermal patch/combined vaginal
ring – 0.2 per 100 woman years
Male condom/female condom - 2-15 per 100 woman years
Diaphragms/caps – about 5 per 100 woman years
Female sterilisation – 1 in 200 lifetime risk of failure
Male sterilisation – 1 in 2000 lifetime risk (after 2 negative semen analyses)
Intrauterine device – <0.5 per 100 woman years
What are the surgical methods used for abortion?
suction curettage - between 7-13 weeks
dilation and evacuation,, proceeded by cervical preparation - after 13 weeks safe and effective
What are the medical methods for abortion?
antiprogesterone and prostaglandin are most effective at <7 weeks - can also be used 7-9 weeks and mid trimester 13-24 weeks
foeticide preformed (KCL into umbilical cord or fatal heart) beyond 22 weeks
What are the complications of abortions?
haemorrhage infection uterine peroration cervical trauma at time of surgical abortion failure
What is candidiasis/thrush?
infection with candida albicans
found in 20% women
What are the RFs for candidiasis?
pregnancy
diabetes
antibiotic use
How does candida present?
asymptomatic
cottage cheese discharge with vulval irritation and itching
superficial dyspareunia and dysuria
vagina is inflamed and red
What is the treatment for candidiasis?
topical imidazole
oral fluconazole
What is bacterial vaginosis?
normal lactobacilli overgrown by mixed flora
12% women
How does bacterial vaginosis present?
grey-white discharge but vagina not red/itchy
characteristic fishy odour
raised vaginal pH