SGUL - Physiology 2 > Contraception > Flashcards

Contraception Flashcards

(41 cards)

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1
Q

What are some methods of contraception that require ongoing action by the individual?

A
  • Oral contraception
  • Barrier methods
  • Fertility awareness
  • Coitus interrupts
  • Oral emergency contraception
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2
Q

What are some methods that prevent contraception by default?

A
  • IUCD/IUI/IUS
  • Progestogen Implants
  • Progestogen Injections
  • Sterilisation
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3
Q

What is seen as the perfect contraception method?

A
  • 100% Reliable
  • 100% Safe
  • Non user dependent
  • Unrelated to coitus
  • Visible to the women
  • No ongoing medicinal input
  • Completely reversible in 24 hrs
  • No discomfort
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4
Q

What are some risks of treatment for contraception?

A
  • Cardiovascular problems: Arterial, Venous
  • Neoplastic: Breast Cancer, Liver
  • Emotional
  • Injection related
  • Allergic
  • Iatrogenic
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5
Q

What are the risks of no treatment for contraception?

A
  • Childbirth related
  • Abortion related
  • Social costs
  • Economic costs
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6
Q

What are the benefits of treatment for contraception?

A
  • Non contraceptive
  • Psychosexual
  • Choice
  • Sexual Health
  • Cost saving
  • Female equality
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7
Q

What are the benefits of no treatment for contraception?

A
  • Non interference
  • Population growth
  • Control of women
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8
Q

What are some combined oral contraceptions?

A
  • Oestrogen: EthinylOestradiol 20,30,35,50 micrograms

Progestogen
- Older 2nd gen: Norethisterone & Levonorgestal
- Newer 3rd gen: Desogestral, Gestodene & Norgestimate
- Latest: Drospirenone

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9
Q

Where do Oestrogen act?

A
  • Act on the Anterior pituitary & Hypothalamus glands
  • Directly on the ovary
  • On the endometrium
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10
Q

Where does Progestogen act?

A
  • Act on the Anterior pituitary & Hypothalamus glands
  • Directly on the Ovary
  • On the endometrium
  • On the fallopian tubes
  • On cervical mucus
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11
Q

What are the benefits of using combined oral contraception?

A
  • Reliable
  • Safe
  • Unrelated to coitus
  • Women in control
  • Rapidly reversible
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12
Q

What are the benefits of using non contraceptive oral contraception???

A
  • Halve ca ovary
  • Halve ca endometrium
  • Helps endometriosis, menorrhagia, dysmenorrhea
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13
Q

State the Pill rules about taking combined oral contraception

A
  • Start 1st packet 1st day of a menstrual period
  • Take 21 pills and stop for 7 day break (PFI)
  • Restart each new packet on 8th day (same)
  • Do not start new packets late
  • If late or missed pills in first 7 days, then use condoms
  • If missed pills in last 7 days no PFI
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14
Q

What are some interacting medications for combined oral contraception?

A
  1. Liver enzyme inducing drugs
    - Affect metabolising of both oestrogen and Progestogen
    - Beware rifampicin and anti-epileptics
  2. Broad spectrum antibiotics
    - Affect enterohepatic circulation of oestrogen only 40%
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15
Q

What is combined vaginal contraceptive?

A
  • Same as COCP except vaginal delivery (ring) for 21 days
  • Remove for 7 days
  • Advantage is that you don’t have to take everyday
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16
Q

What are the Progestogen only methods for contraception?

A
  1. Default methods
    - Implants: Nexplanon, Norplant
    - Hormone releasing IUCD: Mirena IUS
  2. User dependent methods
    - Norethisterone, Ethynodiol diacetate
  3. Injectables
    - Depo Provera, Noristerat
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17
Q

Why is cerelle better than older POPs?

Study These Flashcards
A
  • As effective as COCP
  • No oestrogen: CIs e.g. breastfeeding
  • Favourable side effect profile vs older POPs
  • Bleeding as predictable as COCP
  • 12 hour window
18
Q

What are IUCDs?

Study These Flashcards
A

Copper bearing intrauterine contraceptive devices are inserted into the uterus by suitably trained practitioners and May be left in situ long term and act by:
- Destroying spermatozoa
- Preventing implantation: inflammatory reaction and prostaglandin secretion as well as a mechanical effect

19
Q

What are the different types of IUCD’s?

Study These Flashcards
A
  1. Copper bearing
    - Ortho T 380 – 8 -12yr
    - Multiload 375 – 5yr
    - Multiload 250 – 5y
    - Nova T 380 – 5yr
    - Nova T 200 – 5yr
    - GyneFix (IUI) – 5y
  2. Hormone bearing
20
Q

What are some benefits of using IUCDs?

Study These Flashcards
A
  • Non user dependent
  • Immediately and retrospectively effective
  • Immediately reversible
  • Can be used long term
  • Extremely reliable
  • Unrelated to coitus
  • Free from serious medical dangers
21
Q

What are some disadvantages of using IUCDs?

Study These Flashcards
A
  • Has to be fitted by trained medical personnel
  • Fitting may cause pain or discomfort
  • Periods may become heavier & painful
  • It does not offer protection against infection
  • Threads may be felt by the male
22
Q

List some risks of using IUCD’s as contraception?

Study These Flashcards
A
  • Miscarriage if left in situ if a pregnancy
  • ?ectopics
  • May be expelled
  • The uterus may be perforated
23
Q

List some contraindications when deciding to use IUCDs

Study These Flashcards
A
  • Current pelvic inflammatory disease
  • Suspected or known pregnancy
  • Unexplained vaginal bleeding
  • Abnormalities of the uterine cavity
24
Q

List some relative contraindications when deciding to use IUCDs

Study These Flashcards
A
  • Nulliparity
  • Past history of pelvic inflammatory disease
  • Not in mutually monogamous relationship
  • Menorrhagia / Dysmenorrhoea
  • Small uterine fibroids
25
List the advantages of using condoms in males
- Man in control - Protects against STIs - No serious health risks - Easily available (free at Family Planning clinics)
26
List the disadvantages of using condoms in males
- Last minute use - Needs to be taught - May cause allergies - May cause psycho sexual difficulties - Higher failure rate among some couples - Oily preparations rot rubber
27
List the advantages of using condoms in females
- Woman in control - Protects against STIs - Can be put in advance and left inside after erection lost - Not dependent on male erection to work
28
List the disadvantages of using condoms in females
- Obtrusive - Expensive - Messy - Rustles during sex - Uncertain failure rate
29
What are the different types of caps used in contraception?
- Diaphragm Caps - Suction (cervical) caps
30
Describe the use of diaphragm caps in contraception
- Made of latex - Fit across vagina - Sizes 55 – 95mm in 5mm jumps - Must be used with spermicide and left in at least 6 hours after sexual intercourse
31
Describe the use of Suction (Cervical) caps in contraception
- Made of plastic - Suction to cervix or vaginal vault - Different sizes - Must be used with spermicide and left in 6 hours or more
32
What are the advantages of using diaphragm caps as contraception?
- Woman in Control - Can be put in advance - Offers protection against cervical dysplasias - Perceived as “natural”
33
What are the disadvantages of using diaphragm caps as contraception?
- Diaphragm Caps - Needs to be taught - Messy - Higher failure rate than most other methods - Higher UTI - Higher Candiasis
34
What are the advantages of using suction caps as contraception?
- Suitable for women with poor pelvic muscles - No problems with rubber allergies - Very unobtrusive - Woman in control
35
What are the disadvantages of using suction caps as contraception?
- Needs an accessible and suitable cervix - Higher failure rate than diaphragm - Not easy to find experienced teacher
36
What are some fertility awareness signs you have to be vary about?
- Prediction of ovulation ? 14/7 before period - Sperm can survive 5 days in female tract - Ova can survive 24 hours - Ova are fertilised in the fallopian tube and take 4 days to reach the uterus and implant - Cervical mucus is receptive to sperm around the time of ovulation - Use Periodic Abstinence/alternative contraception to avoid pregnancy - Time intercourse to pre-ovulatory phase to conceive
37
List some factors you take into consideration for natural family planning
- Temperature - Rhythm - Cervix position - Cervical mucus - Persona - Lactational amenorrhoea (LAM)
38
List the advantages about fertility awareness
- Non medical - Can be used in 3rd world - Allowed by Catholic church - Can result in closeness of understanding between partners
39
List the disadvantages about fertility awareness
- Failure rate heavily user dependent - Requires skilled teaching - May require cooperation between partners - May involve limiting sexual activity - Can cause strain
40
What are some emergency forms of contraceptions?
- Postcoital pills: prevents Up to 72 hours after unprotected sexual intercourse (UPSI) - Schering PC4: prevents 3 out of 4 pregnancies which would have occurred - Copper bearing IUCDs: Prevents Up to 5 days after presumed ovulation or 5 days after one single episode of UPSI at any time of the cycle, Failure extremely rare - Levonelle: prevents 7 out of 8 pregnancies - ellaOne (ulipristal): Similar to levonelle
41
Describe the postcoital pills: Levonelle
- Levonelle 2 consists of 2 tablets each containing 750 micrograms of Levonorgestrel - 1.5mg one dose
SGUL - Physiology 2
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