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Repro > 20 - Contraception > Flashcards

20 - Contraception Flashcards

1
Q

define the pearl index?

A

the number of contraceptive failures per 100 women-years of exposure

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2
Q

what statistical tool is used for providing contraceptive failure rate?

A

Life Table Analysis

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3
Q

what is LARC?

A

long-acting reversible contraception

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4
Q

what is a benefit of using LARC?

A

minimises user input and so minimises user failure rates

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5
Q

2 ways in which LARC may fail?

A

Method failure

user failure

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6
Q

what is the % of women who will get pregnant while using no contraception?

A

80%

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7
Q

if male condom is used correctly and every time, what % will result in pregnancy?

A

2%

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8
Q

which method of contraception (except sterilisation + vasectomy) is most effective against pregnancy?

A

Implant

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9
Q

when is the highest chance of getting pregnant?

A

sex on days 8 - 19

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10
Q

how long does the egg survive?

A

24 hours

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11
Q

how long does sperm survive?

A

95 % - less than 4 days

5% - up to 7 days

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12
Q

what are the 3 types of combined hormonal contraceptions?

A

pill

patch

vaginal ring

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13
Q

which hormones are used in the combined hormonal contraception?

A

EE (ethinyl estradiol)

synthetic progesterone

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14
Q

what regime must combined hormonal contraception follow?

A

Standard regime = 21 days with a hormone free week

BUT

Can have tailored regimes - e.g. without having withdrawal bleeds

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15
Q

describe the combined pill - when should it be taken?

A

taken daily - anytime in 24 hours

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16
Q

give 2 disadvantages of the combined pill?

A

have to remember taking it every day

not suitable for those with GI upset

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17
Q

what is the combined patch called?

A

patch EVRA

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18
Q

how often is the patch EVRA changed?

A

weekly

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19
Q

name a possible side effect of patch EVRA?

A

skin reactions

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20
Q

what is the combined ring called?

A

Nuvaring

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21
Q

how often is Nuvaring changed?

A

every 3 weeks

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22
Q

when can Nuvaring be taken out and when might people choose to do so?

A

can be taken out for 3 hours/ 24 hours - might want to remove for sex

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23
Q

give 4 symptom-related benefits to combined methods of contraception?

A

Regulate/reduce bleeding

Improve acne

Improve hirsutism

improve PMS (by stopping ovulation)

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24
Q

give 7 more serious conditions which combined methods often reduce?

A

functional ovarian cysts

ovarian cancer

endometrial cancer

benign breast disease

rheumatoid arthritis

colon cancer

osteoporosis

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25
give 6 common side effects of combined methods?
Breast tenderness Nausea Headache Irregular bleeding first 3 months Mood Weight gain
26
give 4 examples of serious risks associated with combined contraception?
DVT/ PE cervical cancer breast cancer MI
27
when does the POP (progesterone-only pill) need to be taken?
Take at the same time every day without a pill-free interval
28
describe 3 contraindications for POP?
frequent GI upset current breast cancer past/ present liver tumours
29
what is the name of the POP an what is its window period?
Desogestrel pill – 12 hour window period
30
why are contraindications less frequent in POP than combined?
oestrogen-free
31
describe 5 progestogenic side effects?
Appetite increase Hair loss/gain Mood change Headache Acne
32
what hormone is injected in 'the jag'?
progesterone
33
what is the dose indicated in the jag?
150 mg 1ml deep
34
whereabouts is the jag given?
into the upper outer quadrant of the buttocks
35
how often is the jag given?
every 13 weeks
36
what type of injection is the jag?
intramuscular
37
describe the 3 actions of the jag?
1 - prevents ovulation 2 - alters cervical mucus therefore hostile to sperm 3 - endometrium is unsuitable for implantation
38
describe 3 advantages to the jag?
Only need to remember every 12-14 weeks 70% women amenorrhoeic after 3 doses Oestrogen-free so few contraindications
39
describe 3 disadvantages to the jag?
delay in return to fertility weight gain Reversible reduction in bone density (risk of osteoporosis)
40
what is the 'rod' called?
Subdermal Progestogen implant Nexplanon
41
how much progesterone does the rod contain?
68 mg
42
describe the action of the progesterone implant?
inhibits ovulation effects cervical mucus
43
describe 3 advantages of the implant?
Can last 3 years (or be removed at any time) No user input needed No causal effect on weight
44
describe 2 possible side effects of the implant?
prolonged/ frequent bleeding mood changes
45
what is the intrauterine device AKA?
the coil
46
what type of contraception is intrauterine contraception?
LARC
47
how long does the coil last?
5 - 10 years use
48
describe 3 advantages for using the coil?
little user imput fitted at any age/ parity side effects stop as soon as it is removed
49
name 3 (small) risks when fitting the coil?
infection perforation expulsion
50
name 2 occasions in which the coil is not suitable?
untreated pelvic infection distorted endometrial cavity
51
name 3 actions of the copper IUD?
toxic to sperm stops sperm reaching egg prevents implantation of fertilised egg
52
what hormones are present in copper IUD?
none
53
a possible side effect of Copper IUD?
make periods heavier/crampier
54
how long does copper IUD last?
5-10 years
55
is copper IUD contraindication to MRI?
No
56
action of levonogestrel IUS?
affects cervical mucus and endometrium stops fertilisation of egg
57
initial side effect of levonogestrel IUS which eases within 4 months?
irregular bleeding
58
which contraception is also licensed to treat HMB and as the progestogenic part of HRT?
Mirena
59
describe 3 methods of emergency contraception?
copper IUD levonorgestrel pill (Levonelle) Ulipristal pill (ellaone)
60
which method of emergency contraception is most effective?
copper IUD
61
when can copper IUD be used as emergency contraception?
within 120 hours of UPSI/ | day 19 of 28 day cycle
62
when does levonorgestrel pill need to be taken as emergency contraception?
within 72 hours
63
when does ulipristal pill need to be taken as an emergency contraception?
within 120 hours
64
which method of emergency contraception has contraindications?
ulipristal pill
65
when should contraception be started to ensure immediate cover?
first 5 days of cycle
66
when can a woman get pregnant after delivery?
21 days after delivery
67
when can woman get pregnant after miscarriage/ abortion?
5 days after
68
when is breast-feeding contraceptive and for how long?
only if feeding every 4 hours and amenorrhoeic - contraceptive for first 6 months
69
which type of contraception are breast-feeding women advised to use?
any
70
is female sterilisation reversible?
no
71
what is a positive side affect of female sterilisation?
reduced risk of ovarian cancer
72
how is vasectomy achieved?
Vas deferens divided and ends cauterised small incision midline scrotum
73
does vasectomy affect testosterone/ sexual function?
no
74
which act is there to offer protection around termination of pregnancy?
1967 UK Abortion Act
75
how many doctors need to sign off an abortion to support a woman's request?
2
76
when can surgical TOP (STOP) be carried out?
5-12 weeks
77
when can medical TOP (MTOP) be carried out?
5-24 weeks
78
which 2 drugs are involved in MTOP?
mifepristone misoprostol
79
which drugs are involved in home MTOP?
misoprostol
80
what is the major longterm effect of abortion?
emotional - depends on mother, reasons for abortion etc.
81
give 5 examples of barrier methods of contraception?
diaphragm cervical cap male condom female condom spermicidal foam

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