T2 L5 :Fertility Control Flashcards
what is another name for the progesterone only pill and what does it contain
Names:
1) progesterone only pill
2) POP
3) Mini-pill
contains progestin only
what does progesterone prevent in the menstrual cycle
ovulation, therefore leading to contraception
what is the mechanism of action of the mini-pill (3 marks)
Prevent ovulation
Thicken cervical mucus
Hostile endometrium
via:1- thickens cervical mucus, so sperm can’t get through
via: 2- Progestogens cause the endometrium to become thin and secretory – it’s a “Hostile endometrium”
So it will not support an ovum
what is the combined pill
If you give estrogens as well as progesterone- there’s suppression of fsh so ovum doesn’t develop
what is the difference in the prevalence of pregnancy in the combined pill and the mini-pill
from 5/100 in the mini-pill to 3/1000 in the combined pill
what is the meaning behind the withdrawal week
drug free week in order for endometrium to degrade-withdrawal bleed, and gives evidence that you are not pregnant- this was thought to reduce the chance of endometrium cancer
what does missing and extending drug free days do
Missing and extending the drug free days – increases pregnancy risk
what are the side effects of taking the pill
diarrhoea
or vomiting/nausea
a headache
bloating
what does taking anti-biotics do to the pill
it can influence gut bacteria and metabolism therefore rendering the pill ineffective- only a very small number of cases
Core drug: Progestogen-only oral contraceptive:
example,
mech of action,
info,
side effects
Norethisterone
Levonorgestrel
inhibits ovulation by suppression LH surge, thicken cervical mucus & render endometrium hostile
Bioavailability: 65-80%
high protein binding
hepatic metabolism
half life of 10 hours
SD: Nausea, vomiting and headache
Core drug
combined pill oral contraceptive
example,
mech of action,
info,
side effects
A mixture of oestrogen and progesterone ( ethinyloestradiol & northisterone )
Progestogen inhibits ovulation by suppression of LH surge, thickens cervical mucus and renders endometrium ‘hostile’. Oestrogen prevents follicular development by suppression of FSH.
half life of 13-10 for oestr-prog
SD: nausea, vomiting and abdominal cramps
what else can female contraceptives be used to treat?
- heavy menstrual bleeding HMB
- dysmenorrhoea
what are the 4 other different types of vaginal contraceptives
silicone ring
Implants- constant progesterone release means that there is no drug free period . SD- irregular bleeding, withdrawal bleed without drug free week
Intrauterine- local inflammatory response so fertilised ovum can’t be implanted into the uterus
IUS-intrauterine system- releases progesterone suppressing ovulation
what can be used to treat period pains
Oral contraceptives
what is the emergency morning after contraception pill
Levo-norgestrel-progesterone agonist- 2 days – blocks the LH surge, preventing ovulation or implantation- (since life wasn’t implanted it never began)
Ulipristal
