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
what is the induced abortion pill
Mifepristone-progesterone antagonist, blocking progesterone, so terminating pregnancy
what is the theory behind male hormonal contraceptives
Block testosterone, but it can take 3 months for sperm production to stop
What are the side effects to male hormonal contraceptives
It caused a decrease in male secondary sexual characteristics such as :
-Male pattern pubic hair
-Muscle development
-Sperm production
-No aggression nor libido
-Regression of genitalia
why does male hormonal contraceptives have such an effect and why isn’t it common
Giving testosterone, prevents endogenous production
Conclusions: The study regimen led to near-complete and reversible suppression of spermatogenesis. The contraceptive efficacy was relatively good compared with other reversible methods available for men. The frequencies of mild to moderate mood disorders were relatively high.
Insufficient market so no marketing
-they don’t have the babies
